Emerging non-13-valent pneumococcal conjugate vaccine (PCV13) serotypes causing adult invasive pneumococcal disease in the late-PCV13 period in Spain
Por:
Gonzalez-Diaz, A, Camara, J, Ercibengoa, M, Cercenado, E, Larrosa, N, Quesada, MD, Fontanals, D, Cubero, M, Marimon, JM, Yuste, J and Ardanuy, C
Publicada:
1 jun 2020
Ahead of Print:
19 nov 2019
Resumen:
Objective: An early reduction of adult invasive pneumococcal disease (IPD) was observed after the 13-valent pneumococcal conjugate vaccine (PCV13) introduction for children in Spain. We analysed the epidemiology of adult IPD in the late-PCV13 period.
Methods: This was a prospective multicentre study of adult IPD involving six hospitals. Strains were serotyped, genotyped and studied for antimicrobial susceptibility. The late-PCV13 period was compared with the pre- and early-PCV13 periods.
Results: A total of 2197 episodes were collectedd-949 in 2008-2009, 609 in 2012-2013 and 639 in 2015-2016. The initial decrease of IPD observed (from 12.3/100 000 to 8.1/100 000; 2008-2009 versus 2012-2013) plateaued in 2015-2016 (8.3/100 000). IPD due to PCV13 serotypes decreased (from 7.7 to 3.5 to 2.3/100 000; p < 0.05), whereas IPD caused by non-PCV13 serotypes increased (from 4.5 to 4.6 to 6.0/100 000; p < 0.05). The most frequent serotypes in the late-PCV13 period were: 8 (15.1%), 3 (10.5%), 12F (7.9%) and 9N (5.4%). These serotypes were related to major genotypes: CC53 (59.8%) and CC404 (30.4%) for serotype 8, CC180 (64.1%) and CC260 (28.1%) for serotype 3, CC989 (91.7%) for serotype 12F and CC67 (84.8%) for serotype 9N. Penicillin-non-susceptibility (21.2%) was associated with serotypes 11A (CC156), 14 (CC156) and 19A (CC320), and macrolide-resistance was related to serotypes 24F and 19A. Rates of pneumococcal meningitis remained stable throughout the periods (ranges 0.9, 0.8 and 1.0/100 000).
Conclusions: The initial decrease of adult IPD observed after PCV13 introduction for children has been balanced by the rise of non-PCV13 serotypes. The spread of antibiotic-resistant lineages related to nonPCV13 serotypes (11A and 24F) could be a threat for the treatment of serious pneumococcal diseases. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Gonzalez-Diaz, A:
Univ Bellvitge IDIBELL, Microbiol Dept, Lhospitalet De Llobregat, Spain
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Camara, J:
Univ Bellvitge IDIBELL, Microbiol Dept, Lhospitalet De Llobregat, Spain
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Ercibengoa, M:
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Resp Infect & Antimicrobial Resistance Grp, Biodonostia Infect Dis Area, San Sebastian, Spain
Donostialdea Integrated Hlth Org, Osakidetza Basque Hlth Serv, Microbiol Dept, San Sebastian, Spain
Cercenado, E:
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Microbiol Dept, Madrid, Spain
Larrosa, N:
Hosp Univ Vall dHebro, Microbiol Dept, Barcelona, Spain
:
UAB, Clin Lab North Metropolitan Area, Hosp Univ Germans Trias & Pujol, Microbiol Dept, Badalona, Spain
Fontanals, D:
IU UAB, Corp Sanitaria Parc Tauli, Microbiol Dept, Sabadell, Spain
Cubero, M:
Univ Bellvitge IDIBELL, Microbiol Dept, Lhospitalet De Llobregat, Spain
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Marimon, JM:
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Resp Infect & Antimicrobial Resistance Grp, Biodonostia Infect Dis Area, San Sebastian, Spain
Donostialdea Integrated Hlth Org, Osakidetza Basque Hlth Serv, Microbiol Dept, San Sebastian, Spain
Yuste, J:
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
ISCIII, Pneumococcal Reference Lab, Ctr Nacl Microbiol, Madrid, Spain
Ardanuy, C:
Univ Bellvitge IDIBELL, Microbiol Dept, Lhospitalet De Llobregat, Spain
ISCIII, Res Network Resp Dis CIBERES, Madrid, Spain
Univ Barcelona, Dept Pathol & Expt Therapeut, Barcelona, Spain
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