Highlights
- •The post-PCV invasive disease potential of 25 pneumococcal serotypes was estimated.
- •The invasive disease potential of non-vaccine types, except 12F, are lower than 19A.
- •Age and disease presentation influence the invasive disease potential of serotypes.
- •Knowledge of invasive disease potential is valuable to assess and design vaccines.
- •Due to the diversity, surveillance of serotypes in carriage and IPD is critical.
Summary
Objectives
Burden of pneumococcal disease depends on the prevalence and invasive disease potential
of serotypes. We aimed to estimate the invasive disease potential of serotypes in
children under 5 years of age by combining data from different settings with routine
immunisation with pneumococcal conjugate vaccines (PCV).
Methods
We conducted a systematic review, supplemented by unpublished data, to identify data
on the frequency of pneumococcal serotypes in carriage and invasive pneumococcal disease
(IPD). We estimated the invasive disease potential of serotypes as the ratio of IPD
in relation to carriage (odds ratio and 95%CI) compared with 19A (reference serotype)
by meta-analysis. We report results based on a random effects model for children aged
0–23, 24–29, and 0–59 months and by invasive clinical syndromes.
Results
In comparison with 19A, serotypes 1, 7F, and 12F had a significantly higher invasive
disease potential in children aged 0–23 and 0–59 months for all IPD and clinical syndromes
(OR > 5). Several non-vaccine types (NVTs) (6C, 15A, 15BC, 16F, 23B, in these two
age groups) had a lower invasive disease potential than 19A (OR 0.1–0.3). NVTs 8,
12F, 24F, and 33F were at the upper end of the invasiveness spectrum.
Conclusions
There is substantial variation among pneumococcal serotypes in their potential to
cause IPD and disease presentation, which is influenced by age and time after PCV
introduction. Surveillance of IPD and carriage is critical to understand the expected
effectiveness of current PCVs (in the longer term) and guide the development of future
vaccines.
Keywords
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References
- Pneumococcal capsules and their types: past, present, and future.Clin Microbiol Rev. 2015; 28: 871-899
- Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites.PLoS Med. 2013; 10e1001517
- Serotype replacement in disease after pneumococcal vaccination.Lancet. 2011; 378: 1962-1973
- Temporal and geographic stability of the serogroup-specific invasive disease potential of Streptococcus pneumoniae in children.J Infect Dis. 2004; 190: 1203-1211
- Clinical implications of pneumococcal serotypes: invasive disease potential, clinical presentations, and antibiotic resistance.J Korean Med Sci. 2013; 28: 4-15
- Genetic basis for the structural difference between Streptococcus pneumoniae serotype 15B and 15C capsular polysaccharides.Infect Immun. 2003; 71: 6192-6198
- Putatively novel serotypes and the potential for reduced vaccine effectiveness: capsular locus diversity revealed among 5405 pneumococcal genomes.Microbial Genomics. 2016; 2
- Meta-analysis in clinical trials.Cont Clin Trials. 1986; 7: 177-188
- Measuring inconsistency in meta-analyses.Br Med J. 2003; 327: 557-560
- Systematic reviews in health care.Meta-Analysis in Stata. 2001; : 349-367
- Changes in Streptococcus pneumoniae serotype distribution in invasive disease and nasopharyngeal carriage after the heptavalent pneumococcal conjugate vaccine introduction in Bogota, Colombia.Vaccine. 2013; 31: 4033-4038
- Pneumococcal carriage and invasive disease in children before introduction of the 13-valent conjugate vaccine: Comparison with the era before 7-valent conjugate vaccine.Pediatr Infect Dis J. 2013; 32: e45-e53
- Invasive disease potential of pneumococci before and after the 13-valent pneumococcal conjugate vaccine implementation in children.Vaccine. 2015; 33: 6178-6185
- Pneumococcal sequence type replacement among American Indian children: A comparison of pre- and routine-PCV7 eras.Vaccine. 2012; 30: 2376-2381
- Capsular serotype-specific attack rates and duration of carriage of Streptococcus pneumoniae in a population of children.J Infectious Dis. 2006; 194: 682-688
- Pneumococcal serotype evolution/replacement 4 years after introduction of the 13 valent conjugate vaccine use into the infant vaccination program in Belgium.in: Proceedings of the 10th international symposium on pneumococci & pneumococcal diseases, Glasgow, UK. 2016: 353
- Non-vaccine pneumococcal serotypes in adults aged ≥25 years pre-and post-pneumococcal conjugate vaccine introduction in South Africa.in: Proceedings of the 10th international symposium on pneumococci & pneumococcal diseases, Glasgow, UK. 2016: 356
- Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999-2011(1.).Emerg Infect Dis. 2013; 19: 1074-1083
- Molecular characterization of Streptococcus pneumoniae serotype 12F isolates associated with rural community outbreaks in Alaska.J Clin Microbiol. 2013; 51: 1402-1407
- Changes in serotype distribution may hamper efficacy of pneumococcal conjugate vaccines in children.Scand J Infect Dis. 2001; 33: 848-850
- Age- and serotype-specific pediatric invasive pneumococcal disease: insights from systematic surveillance in Santiago, Chile, 1994-2007.J Infect Dis. 2008; 198: 1809-1817
- Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005.J Infect Dis. 2008; 197: 1016-1027
- Increase of serotypes 15A and 23B in IPD in Germany in the PCV13 vaccination era.BMC Infect Dis. 2015; 15: 207
- Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014.Euro Surveill. 2016; 21: 30423
- Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates causing invasive and noninvasive pneumococcal diseases in Korea from 2008 to 2014.Biomed Res Inte. 2016; 20166950482
- Systematic evaluation of serotypes causing invasive pneumococcal disease among children under five: The Pneumococcal Global Serotype Project.PLoS Med. 2010; 7e1000348
- Which pneumococcal serogroups cause the most invasive disease: Implications for conjugate vaccine formulation and use, part I.Clin Infect Dis. 2000; 30: 100-121
- The epidemiology of pneumococcal, meningococcal, and Haemophilus disease in the Middle East and North Africa (MENA) region–current status and needs.Vaccine. 2007; 25: 1935-1944
- Early pneumococcal colonization and serotype diversity in the nasopharynx of Blangadeshi infants: A longitudinal study.in: Proceedings of the 10th International Symposium on Pneumococci & Pneumococcal Diseases; 2016, Glasgow, UK2016: 311
- Serotype specific invasive capacity and persistent reduction in invasive pneumococcal disease.Vaccine. 2010; 29: 283-288
- Association of serotype with risk of death due to pneumococcal pneumonia: A Meta-Analysis.Clin Infect Dis. 2010; 51: 692-699
- Outbreak of invasive Streptococcus pneumoniae serotype 12F among a marginalized inner-city population in Winnipeg, Canada, 2009-2011.Clin Infect Dis. 2014; 59: 651-657
- Insight into resistance phenotypes of emergent non 13-valent pneumococcal conjugate vaccine type pneumococci isolated from invasive disease after 13-valent pneumococcal conjugate vaccine implementation in France.Open Forum Infect Dis. 2016; 3 (ofw020)
- Emergence of Streptococcus pneumoniae serotype 12F after sequential introduction of 7- and 13-valent vaccines, Israel.Emerg Infect Dis. 2018; 24: 453-461
- Long-term impact of PCV7 and PCV13 on pneumococcal meningtitis in children.in: Proceedings of the 10th International Symposium on Pneumococci & Pneumococcal Diseases; 2016. 2016: 223
- An increase of invasive pneumococcal disease caused by serotype 24F in Norway coincides with a clonal change and severe disease episode.in: Proceedings of the 10th International Symposium on Pneumococci & Pneumococcal Diseases; 2016, Glasgow, UK2016: 395
- Shifting genetic structure of invasive serotype 19A pneumococci in the United States.J Infectious Dis. 2011; 203: 1360-1368
- Serotype distribution in non-bacteremic pneumococcal pneumonia: association with disease severity and implications for pneumococcal conjugate vaccines.PLoS One. 2013; 8: e72743
- Indirect effects of childhood pneumococcal conjugate vaccination on invasive pneumococcal disease: a systematic review and meta-analysis.Lancet Global Health. 2017; 5: e9-51
Article info
Publication history
Published online: July 02, 2018
Accepted:
June 11,
2018
Received in revised form:
April 24,
2018
Received:
October 11,
2017
Identification
Copyright
© 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
