1
|
Zhou M, Wang Z, Zhang L, Kudinha T, An H, Qian C, Jiang B, Wang Y, Xu Y, Liu Z, Zhang H, Zhang J. Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study. Front Microbiol 2022; 12:798750. [PMID: 35095809 PMCID: PMC8793633 DOI: 10.3389/fmicb.2021.798750] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background:Streptococcus pneumoniae is an important human pathogen that can cause severe invasive pneumococcal diseases (IPDs). The aim of this multicenter study was to investigate the serotype and sequence type (ST) distribution, antimicrobial susceptibility, and virulence of S. pneumoniae strains causing IPD in China. Methods: A total of 300 invasive S. pneumoniae isolates were included in this study. The serotype, ST, and antimicrobial susceptibility of the strains, were determined by the Quellung reaction, multi-locus sequence typing (MLST) and broth microdilution method, respectively. The virulence level of the strains in the most prevalent serotypes was evaluated by a mouse sepsis model, and the expression level of well-known virulence genes was measured by RT-PCR. Results: The most common serotypes in this study were 23F, 19A, 19F, 3, and 14. The serotype coverages of PCV7, PCV10, PCV13, and PPV23 vaccines on the strain collection were 42.3, 45.3, 73.3 and 79.3%, respectively. The most common STs were ST320, ST81, ST271, ST876, and ST3173. All strains were susceptible to ertapenem, levofloxacin, moxifloxacin, linezolid, and vancomycin, but a very high proportion (>95%) was resistant to macrolides and clindamycin. Based on the oral, meningitis and non-meningitis breakpoints, penicillin non-susceptible Streptococcus pneumoniae (PNSP) accounted for 67.7, 67.7 and 4.3% of the isolates, respectively. Serotype 3 strains were characterized by high virulence levels and low antimicrobial-resistance rates, while strains of serotypes 23F, 19F, 19A, and 14, exhibited low virulence and high resistance rates to antibiotics. Capsular polysaccharide and non-capsular virulence factors were collectively responsible for the virulence diversity of S. pneumoniae strains. Conclusion: Our study provides a comprehensive insight into the epidemiology and virulence diversity of S. pneumoniae strains causing IPD in China.
Collapse
Affiliation(s)
- Menglan Zhou
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Ziran Wang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Li Zhang
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Timothy Kudinha
- School of Biomedical Sciences, Charles Sturt University, Orange, NSW, Australia
- NSW Health Pathology, Regional and Rural, Orange Hospital, Orange, NSW, Australia
| | - Haoran An
- Department of Basic Medical Science, School of Medicine, Tsinghua University, Beijing, China
- Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing, China
| | - Chenyun Qian
- Department of Basic Medical Science, School of Medicine, Tsinghua University, Beijing, China
- Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing, China
| | - Bin Jiang
- Department of Clinical Laboratory, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Yao Wang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Yingchun Xu
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
| | - Zhengyin Liu
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Zhengyin Liu,
| | - Hong Zhang
- Department of Clinical Laboratory, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, China
- Hong Zhang,
| | - Jingren Zhang
- NSW Health Pathology, Regional and Rural, Orange Hospital, Orange, NSW, Australia
- Department of Basic Medical Science, School of Medicine, Tsinghua University, Beijing, China
- Jingren Zhang,
| |
Collapse
|
2
|
Toda H, Tanaka Y, Satoh K, Komatsu M, Wada Y, Tobe T, Kamisako T. Epidemiological and molecular characterization of invasive Streptococcus pneumoniae isolated following introduction of 7-valent conjugate vaccine in Kinki region, Japan, 2008-2013. J Infect Chemother 2019; 26:451-458. [PMID: 31870586 DOI: 10.1016/j.jiac.2019.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/14/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022]
Abstract
Streptococcus pneumoniae is one of the most common bacteria causing community-acquired pneumonia and meningitis. The use of 7-valent pneumococcal conjugate vaccine (PCV7) has reduced the incidence of pneumococcal disease while changing pneumococcal population through herd immunity and non-vaccine pneumococci replacement. This study investigated molecular epidemiologic characteristics of pneumococcal strains in the Kinki region of Japan from 2008 to 2013. A total of 159 invasive pneumococcal isolates were characterized by serotyping, antibiotic susceptibility testing, PCR analysis of penicillin-binding protein genes, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). In adult populations, pediatric PCV7 introduction decreased isolates expressing PCV7 serotypes via herd immunity and increased isolates expressing non-PCV7 serotypes. The rate of penicillin resistance and isolates with alterations in all three pbp genes was higher in PCV7 type isolates than in non-PCV7 type isolates. In MLST analysis, all of serotype 19F isolates were of the same sequence type, ST236, which is the antimicrobial-resistant clone Taiwan19F-14, and the majority of serotypes 23F and 19A isolates were of ST1437 and ST3111 respectively, which are the predominant clones of antimicrobial-resistant pneumococci in Japan. In PFGE profiles, serotype 6B-ST2224, serotype 19F-ST236, serotype 19A-ST3111, and serotype 23F-ST1437 formed six separate clusters composed of genetically identical strains, and genetically identical serotype 22F-ST433 formed two different clusters between the pre- and post-PCV7 period. The results of molecular analysis suggest the spread and persistence of these identical antimicrobial resistant clones in the Kinki region and genetic changes of epidemic clone serotype 22F-ST433 before and after pediatric PCV7 introduction.
Collapse
Affiliation(s)
- Hirofumi Toda
- Department of Clinical Laboratory, Kindai University Hospital, Japan; Laboratory of Molecular Medical Microbiology, Department of Biomedical Informatics, Osaka University Graduate School of Medicine, Japan.
| | - Yuji Tanaka
- Department of Clinical Laboratory Medicine, Kindai University Faculty of Medicine, Japan
| | - Kaori Satoh
- Clinical Research Center, Kindai University Hospital, Japan
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Tenri Health Care University, Japan
| | - Yasunao Wada
- Department of Clinical Laboratory, Hyogo Medical University Hospital, Japan
| | - Toru Tobe
- Laboratory of Molecular Medical Microbiology, Department of Biomedical Informatics, Osaka University Graduate School of Medicine, Japan
| | - Toshinori Kamisako
- Department of Clinical Laboratory Medicine, Kindai University Faculty of Medicine, Japan
| |
Collapse
|
3
|
Licciardi PV, Tan EL, Li P, Ng OT. Pneumococcal vaccination for HIV-infected individuals in Singapore. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105818773773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Susceptibility to infections with pneumococcal bacteria ( Streptococcus pneumoniae) is substantially higher among human immunodeficiency virus (HIV)-infected individuals, and accounts for a significant burden of morbidity and healthcare costs. Pneumococcal vaccination is recommended in most countries for HIV-infected adults. Current policy in Singapore and Australia recommends the use of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) as a booster dose following the use of 13-valent pneumococcal conjugate vaccine (PCV13). Despite this, adherence to this policy has been suboptimal in Singapore. This may be related to the fact that PPSV23 has not been shown to have any impact on pneumococcal carriage (the necessary prerequisite for disease development). PPSV23 has also been associated with immune hyporesponsiveness, raising concerns over the use of this vaccine globally and, in particular, in high-risk populations. The lack of data from studies comparing PCV13 and PPSV23 has also contributed to the suboptimal uptake of pneumococcal vaccines by healthcare professionals for HIV-infected individuals. This review article discusses the key issues and importance of rigorous pneumococcal vaccination programmes for HIV-infected individuals. Current recommendations for pneumococcal vaccination of HIV-infected individuals in Singapore should be adopted more readily to reduce the burden of pneumococcal disease in this high-risk group.
Collapse
Affiliation(s)
- Paul V Licciardi
- Pneumococcal Research Group, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | - Eng Lee Tan
- Centre for Biomedical & Life Sciences, Singapore Polytechnic, Singapore
- Department of Paediatrics, University Children’s Medical Institute, National University Hospital, Singapore
| | - Peng Li
- Centre for Biomedical & Life Sciences, Singapore Polytechnic, Singapore
| | - Oon Tek Ng
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| |
Collapse
|
4
|
Tai SS. Streptococcus pneumoniae Serotype Distribution and Pneumococcal Conjugate Vaccine Serotype Coverage among Pediatric Patients in East and Southeast Asia, 2000-2014: a Pooled Data Analysis. Vaccines (Basel) 2016; 4:E4. [PMID: 26907356 PMCID: PMC4810056 DOI: 10.3390/vaccines4010004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/24/2016] [Accepted: 02/14/2016] [Indexed: 11/29/2022] Open
Abstract
Pneumococcal infection is one of the leading causes of death worldwide, especially in children of developing and underdeveloped countries. Capsular polysaccharide-based vaccines are available for the prevention of this disease. A 7-valent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 for use in children less than two years of age. Subsequently, to broaden the protection, 10-valent (PCV10) and 13-valent (PCV13) vaccines were licensed in 2009 and 2010, respectively. All of these conjugate vaccines elicit an immune response that only provides protection against the infection of S. pneumoniae serotypes included in the formulation. Profiles of S. pneumoniae serotype distribution and serotype coverage for both PCV7 and PCV13 have been reported in some Asian countries/territories. But the published results cannot provide conclusive information due to the difference in studied population and geographic areas. The goals of this review are to obtain an accurate estimate of serotype coverage for PCV7, PCV10, and PCV13 and examine the change in the S. pneumoniae serotype distribution after PCV7 use among pediatric patients in East and Southeast Asia through the analysis of pooled data that were published in the English literature between 2000 and 2014.
Collapse
Affiliation(s)
- Stanley S Tai
- Department of Microbiology, College of Medicine, Howard University, Washington, DC 20059, USA.
| |
Collapse
|
5
|
Huang S, Liu X, Lao W, Zeng S, Liang H, Zhong R, Dai X, Wu X, Li H, Yao Y. Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected at a Chinese hospital from 2011 to 2013. BMC Infect Dis 2015; 15:312. [PMID: 26243258 PMCID: PMC4526307 DOI: 10.1186/s12879-015-1042-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 07/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Streptococcus pneumoniae infections are a major cause of global morbidity and mortality, and the emergence of antibiotic-resistant Streptococcus pneumoniae strains has been increasingly reported. This study provides up-to-date information on bacterial serotype distribution and drug resistance from S. pneumoniae clinical isolates that could guide prevention and treatment strategies for pneumococcal disease in China. METHODS A total of 94 S. pneumoniae isolates were collected from outpatients and inpatients at one Chinese hospital from 2011-2013. Drug susceptibility and resistance was determined by minimum inhibitory concentrations (MICs). Capsular serotypes were identified by the quellung reaction test and multiplex polymerase chain reaction. RESULTS Fifteen serotypes were identified among the 94 S. pneumoniae clinical isolates that were collected. Prevalent serotypes were 19F (42.6 %), 19A (8.5 %), 3 (8.5 %), and 6B (7.4 %). Potential immunization coverage rates for the 7-, 10- and 13-valent pneumococcal polysaccharide conjugate vaccines were 59.6, 62.6, and 79.6 %, respectively. Resistance rates to tetracycline, erythromycin, and trimethoprim/sulfamethoxazole were 91.2, 80.2 and 63.8 %, respectively. Resistance rates to penicillin, amoxicillin, ceftriaxone, and cefotaxime were 47.3, 34.1, 19.8, and 18.7 %, respectively. In almost all cases, antimicrobial resistance of the S. pneumoniae isolates in patients five years or younger was higher than isolates collected from patients aged 51 years or older. CONCLUSION Prevalent serotypes among the 94 S. pneumoniae clinical isolates were 19F, 19A, 3, and 6B. The 13-valent pneumococcal polysaccharide conjugate vaccine covered the majority of the serotypes identified in this sample. Drug resistance varied among different serotypes and age groups. Clinical precautions should be taken to avoid the development of multidrug resistance in this potential human pathogen.
Collapse
Affiliation(s)
- Songyin Huang
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xiaoqiang Liu
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Weisi Lao
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Suhua Zeng
- Department of Ophthalmic Surgery, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
| | - Huiqi Liang
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Rihui Zhong
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xinlu Dai
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xiquan Wu
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Hongyu Li
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Yandan Yao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
- Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
- General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| |
Collapse
|
6
|
Jefferies JM, Mohd Yusof MY, Devi Sekaran S, Clarke SC. Novel clones of Streptococcus pneumoniae causing invasive disease in Malaysia. PLoS One 2014; 9:e97912. [PMID: 24941079 PMCID: PMC4062404 DOI: 10.1371/journal.pone.0097912] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 04/25/2014] [Indexed: 11/19/2022] Open
Abstract
Although Streptococcus pneumoniae is a leading cause of childhood disease in South East Asia, little has previously been reported regarding the epidemiology of invasive pneumococcal disease in Malaysia and very few studies have explored pneumococcal epidemiology using multilocus sequence typing (MLST). Here we describe serotype, multilocus sequence type (ST), and penicillin susceptibility of thirty pneumococcal invasive disease isolates received by the University of Malaya Medical Centre between February 2000 and January 2007 and relate this to the serotypes included in current pneumococcal conjugate vaccines. A high level of diversity was observed; fourteen serotypes and 26 sequence types (ST), (11 of which were not previously described) were detected from 30 isolates. Penicillin non-susceptible pneumococci accounted for 33% of isolates. The extent of molecular heterogeneity within carried and disease-causing Malaysian pneumococci remains unknown. Larger surveillance and epidemiological studies are now required in this region to provide robust evidence on which to base future vaccine policy.
Collapse
Affiliation(s)
- Johanna M. Jefferies
- Faculty of Medicine and Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Respiratory Biomedical Research Unit, Southampton, United Kingdom
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Yasim Mohd Yusof
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shamala Devi Sekaran
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Stuart C. Clarke
- Faculty of Medicine and Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Respiratory Biomedical Research Unit, Southampton, United Kingdom
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Public Health England, Southampton, United Kingdom
- University of Southampton Malaysia Campus, Nusajaya, Malaysia
- * E-mail:
| |
Collapse
|
7
|
Genetic diversity of Streptococcus pneumoniae causing meningitis and sepsis in Singapore during the first year of PCV7 implementation. Emerg Microbes Infect 2014; 3:e39. [PMID: 26038742 PMCID: PMC4078789 DOI: 10.1038/emi.2014.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/16/2014] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
Abstract
Streptococcus pneumoniae is a major cause of sepsis, meningitis and respiratory
disease worldwide. Pneumococcal conjugate vaccines (PCVs) have now been implemented in
many countries worldwide, including Singapore. To evaluate the effectiveness of these
vaccines, pneumococcal surveillance studies are required. Detailed and unified
pneumococcal epidemiology data are currently scarce in South East Asia. Thus, we present
data on invasive pneumococcal (IPD) isolates from Singapore that could assist in
evaluating the effectiveness of pneumococcal vaccine in Singapore. One hundred and
fifty-nine invasive pneumococcal disease isolates were received by the National Public
Health Laboratory in Singapore between June 2009 and August 2010. Isolates were
characterized using serotyping and multilocus sequence typing. Twenty-four different
serotypes were found, the most common of which were 19A, 3, 7F, 23F, 6B, 14, 8 and 19F (in
rank order). One hundred and two sequence types were observed, of which 38 were novel due
to new alleles or new combinations of already existing alleles. Based on the
Simpson's Index of Diversity, serotypes 3, 6B and 19A were the most genetically
diverse. Novel sequence types were more prevalent among conjugate vaccine serotypes 3, 19F
and 23F and non-conjugate vaccine serotype 8, serogroup 15 and in non-typable isolates. We
have demonstrated considerable genetic diversity among invasive pneumococci before and
during the widespread use of conjugate vaccines in Singapore. Approximately half of all
novel IPD clones identified in this study were non-conjugate vaccine serotypes. Although
PCVs would target the most common serotypes, the high genetic diversity in non-vaccine
serotypes would require further surveillance studies.
Collapse
|
8
|
Le CF, Jefferies JM, Yusof MYM, Sekaran SD, Clarke SC. The epidemiology of pneumococcal carriage and infections in Malaysia. Expert Rev Anti Infect Ther 2014; 10:707-19. [DOI: 10.1586/eri.12.54] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
9
|
Sequetyping: serotyping Streptococcus pneumoniae by a single PCR sequencing strategy. J Clin Microbiol 2012; 50:2419-27. [PMID: 22553238 DOI: 10.1128/jcm.06384-11] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The introduction of pneumococcal conjugate vaccines necessitates continued monitoring of circulating strains to assess vaccine efficacy and replacement serotypes. Conventional serological methods are costly, labor-intensive, and prone to misidentification, while current DNA-based methods have limited serotype coverage requiring multiple PCR primers. In this study, a computer algorithm was developed to interrogate the capsulation locus (cps) of vaccine serotypes to locate primer pairs in conserved regions that border variable regions and could differentiate between serotypes. In silico analysis of cps from 92 serotypes indicated that a primer pair spanning the regulatory gene cpsB could putatively amplify 84 serotypes and differentiate 46. This primer set was specific to Streptococcus pneumoniae, with no amplification observed for other species, including S. mitis, S. oralis, and S. pseudopneumoniae. One hundred thirty-eight pneumococcal strains covering 48 serotypes were tested. Of 23 vaccine serotypes included in the study, most (19/22, 86%) were identified correctly at least to the serogroup level, including all of the 13-valent conjugate vaccine and other replacement serotypes. Reproducibility was demonstrated by the correct sequetyping of different strains of a serotype. This novel sequence-based method employing a single PCR primer pair is cost-effective and simple. Furthermore, it has the potential to identify new serotypes that may evolve in the future.
Collapse
|
10
|
Jauneikaite E, Jefferies JM, Hibberd ML, Clarke SC. Prevalence of Streptococcus pneumoniae serotypes causing invasive and non-invasive disease in South East Asia: a review. Vaccine 2012; 30:3503-14. [PMID: 22475858 DOI: 10.1016/j.vaccine.2012.03.066] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Streptococcus pneumoniae is a major cause of bacterial infections resulting in significant morbidity and mortality worldwide. Currently, up to 13 serotypes are included in pneumococcal conjugate vaccines (PCVs). However, the serotype formulation of these vaccines was initially designed to protect children against serotypes most commonly causing invasive disease in North America, and may not reflect the serotype distribution across the world. Data regarding pneumococcal epidemiology from the other parts of the world, in particular South East Asia, has not been reviewed. METHODS This systematic literature review analyses published serotype data regarding S. pneumoniae isolates from South East Asian countries (defined as countries belonging to the Association of South East Asian Nations, ASEAN): Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam up to 3rd of March 2012. RESULTS Analysis of data from six ASEAN countries, from which information on pneumococcal serotypes was available, showed that the most common disease causing serotypes (in rank order) were 19F, 23F, 14, 6B, 1, 19A and 3. Serotype distribution of pneumococcal isolates was similar across the ASEAN region. Serotype level data was more commonly reported for pneumococcal isolates causing invasive pneumococcal disease than for those from non-invasive disease. Studies from Malaysia, Thailand and Singapore contributed the largest proportion of pneumococcal isolates, and serotype data, when compared to other ASEAN countries. CONCLUSION This review demonstrates that the majority of IPD causing serotypes in SE Asia are included in currently licensed PCVs. However, PCV's are included in the routine childhood immunisation schedule of only one of the ten countries included in this analysis. Our findings demonstrate the scarcity of information available on serotype prevalence and distribution of pneumococci in SE Asia.
Collapse
Affiliation(s)
- E Jauneikaite
- Infectious Disease Epidemiology Group, Sir Henry Wellcome Laboratories, Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
| | | | | | | |
Collapse
|