1887

Abstract

Purpose. To prevent severe invasive pneumococcal infection, pneumococcal conjugate vaccines (PCVs) were introduced in Japan in 2010, and in 2013 a pneumococcal 13-valent conjugate vaccine (PCV13) was included in the routine vaccination schedule for infants. In this study, we analysed the antimicrobial susceptibilities and capsular types of pneumococci isolated from non-invasive patient sites from 2007 to 2016 to assess the impact of the introduction of PCV13.

Methodology. A total of 618 pneumococcal isolates collected at a teaching hospital from 2007 to 2016 were used. These isolates were characterized by capsular typing, multilocus sequence typing and antimicrobial susceptibility testing.

Results. Capsular typing indicated that, after the introduction of the PCV, the proportion of PCV13 serotypes decreased (P<0.01), while non-PCV13 serotypes became diverse. In particular, increases in 22 F, 15A and 23A were noted among non-PCV13 serotypes. Regarding antimicrobial susceptibility, the non-susceptibility rate to penicillin of pneumococci that showed higher minimum inhibitory concentrations (MICs) than the susceptibility breakpoint decreased, and pneumococci tended to become susceptible. However, all type 23A pneumococci and 77.8  % of type 15A pneumococci showed the reverse trend, with low susceptibility to penicillin. Furthermore, all 15A and 23A isolates had macrolide resistance genes.

Conclusion. These data suggest that PCVs can prevent infections caused by PCV serotypes. However, since non-PCV13-type pneumococci, in particular 15A and 23A, which have acquired multidrug resistance, have already emerged over time, the development of a novel vaccine targeting a broader spectrum of pneumococci is warranted.

Keyword(s): capsular type , non-vaccine type and PCV
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2019-05-15
2024-03-29
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References

  1. Ubukata K, Morozumi M, Sakuma M, Takata M, Mokuno E et al. Etiology of acute otitis media and characterization of pneumococcal isolates after introduction of 13-valent pneumococcal conjugate vaccine in Japanese children. Pediatr Infect Dis J 2018; 37:598–604 [View Article]
    [Google Scholar]
  2. García E, López R. Molecular biology of the capsular genes of Streptococcus pneumoniae. FEMS Microbiol Lett 1997; 149:1–10 [View Article]
    [Google Scholar]
  3. Geno KA, Bush CA, Wang M, Jin C, Nahm MH et al. WciG O-acetyltransferase functionality differentiates pneumococcal serotypes 35C and 42. J Clin Microbiol 2017; 55:2775–2784 [View Article]
    [Google Scholar]
  4. Richter SS, Heilmann KP, Dohrn CL, Riahi F, Diekema DJ et al. Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999–2011(1.). Emerg Infect Dis 2013; 19:1074–1083 [View Article]
    [Google Scholar]
  5. Weinberger DM, Malley R, Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet 2011; 378:1962–1973 [View Article]
    [Google Scholar]
  6. Ubukata K, Chiba N, Hanada S, Morozumi M, Wajima T et al. Serotype changes and drug resistance in invasive pneumococcal diseases in adults after vaccinations in children, Japan, 2010–2013. Emerg Infect Dis 2015; 21:1956–1965 [View Article]
    [Google Scholar]
  7. Lehtinen P, Jartti T, Virkki R, Vuorinen T, Leinonen M et al. Bacterial coinfections in children with viral wheezing. Eur J Clin Microbiol Infect Dis 2006; 25:463–469 [View Article]
    [Google Scholar]
  8. Elberse KE, van de Pol I, Witteveen S, van der Heide HG, Schot CS et al. Population structure of invasive Streptococcus pneumoniae in The Netherlands in the pre-vaccination era assessed by MLVA and capsular sequence typing. PLoS One 2011; 6:e20390 [View Article]
    [Google Scholar]
  9. Leung MH, Bryson K, Freystatter K, Pichon B, Edwards G et al. Sequetyping: serotyping Streptococcus pneumoniae by a single PCR sequencing strategy. J Clin Microbiol 2012; 50:2419–2427 [View Article]
    [Google Scholar]
  10. Nagai K, Shibasaki Y, Hasegawa K, Davies TA, Jacobs MR et al. Evaluation of PCR primers to screen for Streptococcus pneumoniae isolates and beta-lactam resistance, and to detect common macrolide resistance determinants. J Antimicrob Chemother 2001; 48:915–918 [View Article]
    [Google Scholar]
  11. Noguchi N, Tano J, Nasu Y, Koyama M, Narui K et al. Antimicrobial susceptibilities and distribution of resistance genes for beta-lactams and macrolides in Streptococcus pneumoniae isolated between 2002 and 2004 in Tokyo. Int J Antimicrob Agents 2007; 29:26–33 [View Article]
    [Google Scholar]
  12. Clinical and Laboratory Standards Institute Performance standards for antimicrobial susceptibility testing. , Twenty-Fifth informational supplement. Document M100-S25. Wayne, PA: CLSI; 2015
  13. Pan XS, Yague G, Fisher LM. Quinolone resistance mutations in Streptococcus pneumoniae GyrA and ParC proteins: mechanistic insights into quinolone action from enzymatic analysis, intracellular levels, and phenotypes of wild-type and mutant proteins. Antimicrob Agents Chemother 2001; 45:3140–3147 [View Article]
    [Google Scholar]
  14. Enright MC, Spratt BG. A multilocus sequence typing scheme for Streptococcus pneumoniae: identification of clones associated with serious invasive disease. Microbiology 1998; 144:3049–3060 [View Article]
    [Google Scholar]
  15. Ubukata K, Takata M, Morozumi M, Chiba N, Wajima T et al. Effects of pneumococcal conjugate vaccine on genotypic penicillin resistance and serotype changes, Japan, 2010–2017. Emerg Infect Dis 2018; 24:2010–2020 [View Article]
    [Google Scholar]
  16. Keller LE, Robinson DA, McDaniel LS. Nonencapsulated Streptococcus pneumoniae: emergence and pathogenesis. MBio 2016; 7:e01792 [View Article]
    [Google Scholar]
  17. Duvvuri VR, Deng X, Teatero S, Memari N, Athey T et al. Population structure and drug resistance patterns of emerging non-PCV-13 Streptococcus pneumoniae serotypes 22F, 15A, and 8 isolated from adults in Ontario, Canada. Infect Genet Evol 2016; 42:1–8 [View Article]
    [Google Scholar]
  18. Büyükcam A, Güdücüoğlu H, Karaman K, Gürbüz V, Aliyev E et al. Invasive pneumococcal infection due to serotype 15A after the pneumococcal conjugate vaccine implementation in Turkey. Hum Vaccin Immunother 2017; 13:1892–1894 [View Article]
    [Google Scholar]
  19. Cho YC, Chiu NC, Lu CY, Huang DT, Huang FY et al. Redistribution of Streptococcus pneumoniae serotypes after nationwide 13-valent pneumococcal conjugate vaccine program in children in northern Taiwan. Pediatr Infect Dis J 2017; 36:e334–e340 [View Article]
    [Google Scholar]
  20. Demczuk WHB, Martin I, Hoang L, Van Caeseele P, Lefebvre B et al. Phylogenetic analysis of emergent Streptococcus pneumoniae serotype 22F causing invasive pneumococcal disease using whole genome sequencing. PLoS One 2017; 12:e0178040 [View Article]
    [Google Scholar]
  21. Skinner JM, Indrawati L, Cannon J, Blue J, Winters M et al. Pre-clinical evaluation of a 15-valent pneumococcal conjugate vaccine (PCV15-CRM197) in an infant-rhesus monkey immunogenicity model. Vaccine 2011; 29:8870–8876 [View Article]
    [Google Scholar]
  22. Greenberg D, Hoover PA, Vesikari T, Peltier C, Hurley DC et al. Safety and immunogenicity of 15-valent pneumococcal conjugate vaccine (PCV15) in healthy infants. Vaccine 2018; 36:6883–6891 [View Article]
    [Google Scholar]
  23. Lindström V, Aittoniemi J, Lyytikäinen O, Klemets P, Ollgren J et al. Invasive pneumococcal disease in patients with haematological malignancies before routine use of conjugate vaccines in Finland. Infect Dis 2016; 48:399–402 [View Article]
    [Google Scholar]
  24. Regev-Yochay G, Katzir M, Strahilevitz J, Rahav G, Finn T et al. The herd effects of infant PCV7/PCV13 sequential implementation on adult invasive pneumococcal disease, six years post implementation; a nationwide study in Israel. Vaccine 2017; 35:2449–2456 [View Article]
    [Google Scholar]
  25. Hackel M, Lascols C, Bouchillon S, Hilton B, Morgenstern D et al. Serotype prevalence and antibiotic resistance in Streptococcus pneumoniae clinical isolates among global populations. Vaccine 2013; 31:4881–4887 [View Article]
    [Google Scholar]
  26. Nakano S, Fujisawa T, Ito Y, Chang B, Matsumura Y et al. Spread of meropenem-resistant Streptococcus pneumoniae serotype 15A-ST63 clone in Japan, 2012–2014. Emerg Infect Dis 2018; 24:275–283 [View Article]
    [Google Scholar]
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