Genomic features of predominant non-PCV13 serotypes responsible for adult invasive pneumococcal disease in Spain
Por:
Gonzalez-Diaz, A, Berbel, D, Ercibengoa, M, Cercenado, E, Larrosa, N, Quesada, MD, Casabella, A, Cubero, M, Marimon, JM, Dominguez, MA, Carrera-Salinas, A, Camara, J, Martin-Galiano, AJ, Yuste, J, Marti, S and Ardanuy, C
Publicada:
25 ago 2022
Ahead of Print:
1 jul 2022
Resumen:
Background Although pneumococcal conjugate vaccines (PCVs) effectively prevent invasive pneumococcal disease (IPD), serotype replacement has occurred. Objectives We studied the pangenome, antibiotic resistance mechanisms and presence of mobile elements in predominant non-PCV13 serotypes causing adult IPD after PCV13 vaccine introduction in Spain. Methods We conducted a multicentre study comparing three periods in six Spanish hospitals and analysed through whole genome sequencing representative strains collected in the pre-PCV13, early-PCV13 and late-PCV13 periods. Results Among 2197 cases of adult IPD identified, 110 pneumococci expressing non-PCV13 capsules were sequenced. Seven predominant serotypes accounted for 42.6% of IPD episodes in the late-PCV13 period: serotypes 8 (14.4%), 12F (7.5%), 9N (5.2%), 11A (4.1%), 22F (3.9%), 24F (3.9%) and 16F (3.6%). All predominant non-PCV13 serotypes were highly clonal, comprising one or two clonal complexes (CC). In general, CC53(8), CC404(8), CC30(16F), CC433(22F) and CC66(9N), related to predominant non-PCV13 serotypes, were antibiotic susceptible. CC156(11A) was associated with resistance to co-trimoxazole, penicillin and amoxicillin. CC230(24F) was non-susceptible to penicillin and resistant to erythromycin, clindamycin, and tetracycline. Six composite transposon structures of the Tn5252-family were found in CC230(24F), CC989(12F) and CC30(16F) carrying different combinations of erm(B), tet(M), and cat. Pangenome analysis revealed differences in accessory genomes among the different CC, with most variety in CC30(16F) (23.9%) and more conservation in CC156(11A) (8.5%). Conclusions We identified highly clonal predominant serotypes responsible for IPD in adults. The detection of not only conjugative elements carrying resistance determinants but also clones previously associated with vaccine serotypes (CC156(11A) and CC230(24F)) highlights the importance of the accessory genome.
Filiaciones:
Gonzalez-Diaz, A:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Berbel, D:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Ercibengoa, M:
Osakidetza Basque Hlth, Resp Infect & Antimicrobial Resistance Grp, Infect Dis Area, Biodonostia, Donostia San Sebastian, Spain
Cercenado, E:
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Larrosa, N:
UAB, Hosp Univ Vall dHebron, Microbiol Dept, Barcelona, Spain
Res Network Infect Dis CIBERINFEC, ISCIII, Madrid, Spain
:
UAB, Hosp Univ Germans Trias & Pujol, Clin Lab North Metropolitan Area, Microbiol Dept, Badalona, Spain
Casabella, A:
Hosp Univ Parc Tauli, Microbiol Dept, Sabadell, Spain
Cubero, M:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Marimon, JM:
Osakidetza Basque Hlth, Resp Infect & Antimicrobial Resistance Grp, Infect Dis Area, Biodonostia, Donostia San Sebastian, Spain
Dominguez, MA:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Infect Dis CIBERINFEC, ISCIII, Madrid, Spain
Univ Barcelona, Sch Med & Hlth Sci, Dept Pathol & Expt Therapeut, Barcelona, Spain
Carrera-Salinas, A:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Camara, J:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Martin-Galiano, AJ:
Inst Salud Carlos III ISCIII, Natl Ctr Microbiol, Intrahosp Infect Lab, Majadahonda, Spain
Yuste, J:
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Inst Salud Carlos III, Natl Ctr Microbiol, Spanish Pneumococcal Reference Lab, Madrid, Spain
Marti, S:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Univ Barcelona, Sch Med & Hlth Sci, Dept Med, Barcelona, Spain
Ardanuy, C:
Hosp Univ Bellvitge, IDIBELL UB, Microbiol Dept, Barcelona, Spain
Res Network Resp Dis CIBERES, ISCIII, Madrid, Spain
Univ Barcelona, Sch Med & Hlth Sci, Dept Pathol & Expt Therapeut, Barcelona, Spain
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