scholarly journals Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

2015 ◽  
Vol 59 (9) ◽  
pp. 5761-5767 ◽  
Author(s):  
Martha McElligott ◽  
Imelda Vickers ◽  
Mary Meehan ◽  
Mary Cafferkey ◽  
Robert Cunney ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Treatment Strategies ◽  
Significant Decline ◽  
High Rate ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
Conjugate Vaccines ◽  
Vaccine Introduction ◽  
Single Locus Variant

ABSTRACTCarriage and noninvasive pneumococcal isolates frequently have a higher prevalence of antimicrobial nonsusceptibility than invasive isolates. From 2009 to 2014, we determined the associated clones in 169 pediatric noninvasive nonsusceptible pneumococci from a total of 506 isolates collected after 7- and 13-valent conjugate vaccine introduction (PCV7/13) to the Irish childhood immunization schedule in 2008 and 2010, respectively. We compared our results to those from 25 noninvasive pediatric pneumococcal isolates collected in 2007, the year before introduction of conjugate vaccines. In 2007, England14-9 and Spain9V-3 accounted for 12% and 32% of nonsusceptible clones, respectively, but in 2009 to 2014, their prevalence fell to 0% and 2.4%. Furthermore, there was a significant decline in Spain6B-2 and its variants from 2009 to 2014 (P= 0.0024). Fluctuations occurred in clonal complex 320 associated with serotype 19A. The prevalence of Sweden15A-25 and its variants and ST558 (a single-locus variant of Utah35B-24) associated with nonvaccine serotypes (NVT) 15A and 35B increased from 0% and 8% in 2007 to 19% and 16% in 2013 to 2014, respectively. Pilus locus 1 (PI-1) is associated with the spread of some nonsusceptible pneumococcal clones. PI-1 was more frequently associated with PCV7/13 serotypes than NVT (P= 0.0020). Our data highlight the value of surveillance of noninvasive pneumococci following conjugate vaccine introduction. Importantly, emerging clones associated with NVT may limit the effectiveness of PCV7/13 in reducing the high rate of nonsusceptibility among pediatric noninvasive pneumococci, with implications for empirical treatment strategies.

scholarly journals Pneumococci causing invasive disease in children prior to the introduction of pneumococcal conjugate vaccine in Scotland

2006 ◽  
Vol 55 (8) ◽  
pp. 1079-1084 ◽  
Author(s):  
Stuart C. Clarke ◽  
Johanna M. C. Jefferies ◽  
Andrew J. Smith ◽  
Jim McMenamin ◽  
Timothy J. Mitchell ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Rank Order ◽  
Invasive Disease ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
Conjugate Vaccines ◽  
Common Serotypes ◽  
Sequence Types

This study aimed to determine the serotypes and sequence types (STs) of pneumococci causing paediatric invasive disease in Scotland prior to the introduction of pneumococcal conjugate vaccines (PCVs). All invasive pneumococci isolated between 2000 and 2004 from children aged less than 5 years in Scotland were used. The isolates were characterized by serotyping and multi-locus sequence typing. Two hundred and seventeen pneumococci were characterized into 22 different serogroups/types, the most common, in rank order, being 14, 19F, 6B, 18C, 23F, 9V, 4, 1, 19A and 6A. They were further genotyped into 77 different STs, the three most common being 9, 162 and 176. Common serotypes possessed multiple STs, but pneumococci of a particular clone were mostly associated with a particular serotype. The seven most common serotypes are included in the 7-valent polysaccharide conjugate vaccine (PCV7). Serotype coverage for PCV7 was 76.5 % in those aged less than 5 years but increased to 88.9 % for those aged 1 year. The introduction of PCV7 into the childhood immunization schedule would reduce the burden of pneumococcal disease in children, although continued surveillance of invasive pneumococcal disease will be required before, during and after the introduction of PCVs.

scholarly journals Effectiveness of Haemophilus influenzae Type b Conjugate Vaccine Introduction Into Routine Childhood Immunization in Kenya

JAMA ◽  
2006 ◽  
Vol 296 (6) ◽  
pp. 671 ◽  
Author(s):  
Karen D. Cowgill ◽  
Moses Ndiritu ◽  
Joyce Nyiro ◽  
Mary P. E. Slack ◽  
Salome Chiphatsi ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Childhood Immunization ◽  
Vaccine Introduction ◽  
Routine Childhood

scholarly journals Evolution of pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262225
Author(s):  
Sweta M. Patel ◽  
Yazdani B. Shaik-Dasthagirisaheb ◽  
Morgan Congdon ◽  
Rebecca R. Young ◽  
Mohamed Z. Patel ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Conjugate Vaccines ◽  
Vaccine Serotypes ◽  
Vaccine Introduction ◽  
Molecular Serotyping ◽  
Sustained Effect ◽  
Pneumococcal Serotype

Pneumococcal conjugate vaccines reduce the burden of invasive pneumococcal disease, but the sustained effect of these vaccines can be diminished by an increase in disease caused by non-vaccine serotypes. To describe pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in July 2012, we performed molecular serotyping of 268 pneumococcal strains isolated from 221 children between 2012 and 2017. The median (interquartile range) age of the children included in this analysis was 6 (3,12) months. Fifty-nine percent of the children had received at least one dose of PCV-13 and 35% were fully vaccinated with PCV-13. While colonization by vaccine serotypes steadily declined following PCV-13 introduction, 25% of strains isolated more than 3 years after vaccine introduction were PCV-13 serotypes. We also observed an increase in colonization by non-vaccine serotypes 21 and 23B, which have been associated with invasive pneumococcal disease and antibiotic resistance in other settings.

scholarly journals New Vaccine Introduction and Childhood Vaccination Timeliness in Two Urban, Informal Settlements in Nairobi, Kenya

2021 ◽  
Author(s):  
Cara Bess Janusz ◽  
Martin K. Mutua ◽  
Abram L. Wagner ◽  
Matthew L. Boulton
Keyword(s):  
Urban Areas ◽  
Prevalence Ratio ◽  
Childhood Vaccination ◽  
Routine Immunization ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
African Countries ◽  
Vaccine Introduction ◽  
Routine Childhood ◽  
The Impact

New vaccine introduction accompanied by social mobilization activities could contribute to improved routine immunization timeliness. This study assesses the impact of Kenya’s introduction of pneumococcal conjugate vaccine (PCV) on the timeliness of routine childhood vaccination in two informal, urban settlements in Nairobi. Data collected from 2007 to 2015 as part of a demographic surveillance system were used to estimate annual vaccination delays of ≥ 4 weeks among children aged 12–23 months in the period before and after the introduction of PCV in Kenya. Binomial segmented regression models using generalized estimating equations examined the association between vaccine introduction and timeliness of routine immunization. Over half of all children vaccinated in the two urban areas received one or more doses ≥ 4 weeks after the recommended age. The timeliness of routine immunization showed slight improvements or nonsignificant changes during the years following PCV introduction compared with the preceding years (adjusted prevalence ratio [aPR]: 0.67, 95% CI: 0.45–0.99 for Bacille Calmette-Guerin receipt; aPR: 0.59, 95% CI: 0.41–0.83 for third dose Pentavalent receipt; aPR: 1.19, 95% CI: 0.99–1.42 for measles). However, as of 2015, delayed vaccination remained prevalent in children, particularly among the poorest residing in the settlements. Many sub-Saharan African countries have introduced new life-saving vaccines into their routine childhood immunization schedule. Additional evidence regarding the positive or neutral influence of new vaccine introduction on the performance of delivery systems provides further justification to sustain the inclusion of these more costly vaccines in the immunization schedule.

scholarly journals Phylogenetic Analysis of Invasive Serotype 1 Pneumococcus in South Africa, 1989 to 2013

2016 ◽  
Vol 54 (5) ◽  
pp. 1326-1334 ◽  
Author(s):  
Mignon du Plessis ◽  
Mushal Allam ◽  
Stefano Tempia ◽  
Nicole Wolter ◽  
Linda de Gouveia ◽  
...  
Keyword(s):  
South Africa ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Clonal Complex ◽  
Diversity Index ◽  
Factors Associated ◽  
Single Locus Variant ◽  
Serotype 1 ◽  
Sequence Types

Serotype 1 is an important cause of invasive pneumococcal disease in South Africa and has declined following the introduction of the 13-valent pneumococcal conjugate vaccine in 2011. We genetically characterized 912 invasive serotype 1 isolates from 1989 to 2013. Simpson's diversity index (D) and recombination ratios were calculated. Factors associated with sequence types (STs) were assessed. Clonal complex 217 represented 96% (872/912) of the sampled isolates. Following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), ST diversity increased in children <5 years (D, 0.39 to 0.63,P= 0.002) and individuals >14 years (D, 0.35 to 0.54,P< 0.001): ST-217 declined proportionately in children <5 years (153/203 [75%] versus 21/37 [57%],P= 0.027) and individuals >14 years (242/305 [79%] versus 96/148 [65%],P= 0.001), whereas ST-9067 increased (4/684 [0.6%] versus 24/228 [11%],P< 0.001). Three subclades were identified within ST-217: ST-217C1(353/382 [92%]), ST-217C2(15/382 [4%]), and ST-217C3(14/382 [4%]). ST-217C2, ST-217C3, and single-locus variant (SLV) ST-8314 (20/912 [2%]) were associated with nonsusceptibility to chloramphenicol, tetracycline, and co-trimoxazole. ST-8314 (20/912 [2%]) was also associated with increased nonsusceptibility to penicillin (P< 0.001). ST-217C3and newly reported ST-9067 had higher recombination ratios than those of ST-217C1(4.344 versus 0.091,P< 0.001; and 0.086 versus 0.013,P< 0.001, respectively). Increases in genetic diversity were noted post-PCV13, and lineages associated with antimicrobial nonsusceptibility were identified.

scholarly journals Epidemiology of Bacterial Meningitis in the Nine Years Since Meningococcal Serogroup A Conjugate Vaccine Introduction, Niger, 2010–2018

2019 ◽  
Vol 220 (Supplement_4) ◽  
pp. S206-S215 ◽  
Author(s):  
Fati Sidikou ◽  
Caelin C Potts ◽  
Maman Zaneidou ◽  
Sarah Mbaeyi ◽  
Goumbi Kadadé ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Annual Incidence ◽  
Chain Reaction ◽  
Vaccine Introduction ◽  
Meningitis Belt ◽  
Laboratory Surveillance ◽  
Surveillance Programs ◽  
Polymerase Chain

Abstract Background In 2010, Niger and other meningitis belt countries introduced a meningococcal serogroup A conjugate vaccine (MACV). We describe the epidemiology of bacterial meningitis in Niger from 2010 to 2018. Methods Suspected and confirmed meningitis cases from January 1, 2010 to July 15, 2018 were obtained from national aggregate and laboratory surveillance. Cerebrospinal fluid specimens were analyzed by culture and/or polymerase chain reaction. Annual incidence was calculated as cases per 100 000 population. Selected isolates obtained during 2016–2017 were characterized by whole-genome sequencing. Results Of the 21 142 suspected cases of meningitis, 5590 were confirmed: Neisseria meningitidis ([Nm] 85%), Streptococcus pneumoniae ([Sp] 13%), and Haemophilus influenzae ([Hi] 2%). No NmA cases occurred after 2011. Annual incidence per 100 000 population was more dynamic for Nm (0.06–7.71) than for Sp (0.18–0.70) and Hi (0.01–0.23). The predominant Nm serogroups varied over time (NmW in 2010–2011, NmC in 2015–2018, and both NmC and NmX in 2017–2018). Meningococcal meningitis incidence was highest in the regions of Niamey, Tillabery, Dosso, Tahoua, and Maradi. The NmW isolates were clonal complex (CC)11, NmX were CC181, and NmC were CC10217. Conclusions After MACV introduction, we observed an absence of NmA, the emergence and continuing burden of NmC, and an increase in NmX. Niger’s dynamic Nm serogroup distribution highlights the need for strong surveillance programs to inform vaccine policy.

scholarly journals Piliation of Invasive Streptococcus pneumoniae Isolates in the Era before Pneumococcal Conjugate Vaccine Introduction in Malawi

2013 ◽  
Vol 20 (11) ◽  
pp. 1729-1735 ◽  
Author(s):  
Benard W. Kulohoma ◽  
Katherine Gray ◽  
Arox Kamng'ona ◽  
Jennifer Cornick ◽  
Stephen D. Bentley ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Low Frequency ◽  
Sub Saharan Africa ◽  
Type I ◽  
Protein Vaccine ◽  
Childhood Immunization ◽  
Content Type ◽  
Vaccine Introduction

ABSTRACTThe pneumococcal pilus has been shown to be an important determinant of adhesion and virulence in mouse models of colonization, pneumonia, and bacteremia. A pilus is capable of inducing protective immunity, supporting its inclusion in next-generation pneumococcal protein vaccine formulations. Whether this vaccine target is common among pneumococci in sub-Saharan Africa is uncertain. To define the prevalence and genetic diversity of type I and II pili among invasive pneumococci in Malawi prior to the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into routine childhood immunization, we examined 188Streptococcus pneumoniaeisolates collected between 2002 and 2008 (17% serotype 1). In this region of high disease burden, we found a low frequency of invasive piliated pneumococci (14%) and pilus gene sequence diversity similar to that seen previously in multiple global pneumococcal lineages. All common serotypes with pilus were covered by PCV13 and so we predict that pilus prevalence will be reduced in the Malawian pneumococcal population after PCV13 introduction.

The Impact of Haemophilus Influenzae and Streptococcus Pneumoniae Vaccination in Bacterial Meningitis in a Pediatric Referral Hospital in Mexico

2021 ◽  
Author(s):  
Mercedes Macias Parra ◽  
Isabel Medina-Vera ◽  
Eduardo Arias De la Garza ◽  
Miguel A. Rodriguez Weber ◽  
Ximena León-Lara
Keyword(s):  
Risk Factors ◽  
Streptococcus Pneumoniae ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Neurological Complications ◽  
Immunization Schedule ◽  
Conjugate Vaccines ◽  
Factors Associated ◽  
Before And After

Abstract Objective The study aimed to compare the epidemiology of bacterial meningitis (BM) before and after vaccination, and identify possible risk factors associated with mortality. Methods The medical and microbiologic records of children (1 month–18 years) with a discharge diagnosis of BM in a third level children's hospital in Mexico from 1990 to 2018 were reviewed. The epidemiology, pathogens, and outcomes were compared before and after introducing Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines to the Mexican immunization schedule. Risk factors associated with mortality were determined. Results In the 28-year period, 226 cases with BM were included 55.8% (1990–1999), 27.4% (2000–2008), and 16.8% (2009–2018) (p = 0.0001). The most frequent pathogen was Hib, documented in 39% of cases. There was a reduction in neurological complications after introducing the Hib conjugate vaccine (59 vs. 39%; p = 0.003) and sequelae after the Streptococcus pneumoniae conjugate vaccine (43 vs. 35%; p = 0.05). Independent risk factors associated with mortality were coma (odds ratio [OR]: 15 [2.9–78]), intracerebral bleeding (OR: 3.5 [1.4–12]), and pneumococcal meningitis (OR: 9.4 [2.2–39]). Conclusion Since the introduction of Hib and pneumococcal conjugate vaccines to the national immunization schedule, there was a reduction in BM cases, mainly associated with the Hib vaccine, with the consequent reduction of neurological complications and sequelae.

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