Temporal progression of the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease in Galicia (Spain) and its relationship with resistance to antibiotics (period 2011-2021)

  1. Losada-Castillo, Isabel 3
  2. Santiago-Pérez, Isolina 1
  3. Juiz-Gonzalez, Pedro Miguel 2
  4. Méndez-Lage, Susana 2
  5. Purriños-Hermida, María Jesús 4
  6. Malvar, Alberto 1
  7. Agulla-Budiño, José Andrés 2
  1. 1 Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, La Coruña, Santiago de Compostela, Spain
  2. 2 Servizo de Microbioloxía, Complexo Hospitalario Universitario de Ferrol, La Coruña, Ferrol, Spain
  3. 3 Servizo de Calidade Asistencial, Dirección Xeral de Asistencia Sanitaria, Consellería de sanidade, La Coruña, Santiago de Compostela, Spain
  4. 4 Servizo de Admisión, Complexo Hospitalario Universitario de Santiago, La Coruña, Santiago de Compostela, Spain
Show affiliations +
Journal:
Enfermedades Infecciosas y Microbiologia Clinica

ISSN: 0213-005X

Year of publication: 2024

Volume: 42

Issue: 4

Pages: 179-186

Type: Article

DOI: 10.1016/J.EIMC.2022.12.007 SCOPUS: 2-s2.0-85146538990 GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Enfermedades Infecciosas y Microbiologia Clinica

Abstract

Introduction: Streptococcus pneumoniae causes serious diseases in the susceptible population. The 13-valent pneumococci conjugate vaccine (PCV13) was included in the children's calendar in 2011. The objective of the study was to analyze the evolution of pneumococcal serotypes and their resistance after PCV13. Methods: This study included the pneumococci serotyped in Galicia in 2011-2021. Antibiotic susceptibility was analyzed following EUCAST criteria. The data was analyzed in 3 sub-periods: initial (2011-2013), middle (2014-2017) and final (2018-2021). The prevalence of serotypes and their percentage of resistance to the most representative antibiotics were calculated. Results: A total of 2.869 isolates were included. Initially, 42.7% isolates presented capsular types included in PCV13, compared to 15.4% at the end. Those included in PCV20 and not in PCV13 and PCV15 were 12.5% at baseline and 41.3% at the end; 26.4% of the isolates throughout the study had serotypes not included in any vaccine. The prevalence of serotype 8 multiplied almost by 8 and that of 12F tripled. The 19A serotype was initially the most resistant, while the resistance of serotypes 11A and 15A increased throughout the study. Conclusions: The introduction of PCV13 in the pediatric population determined a change in pneumococcal serotypes towards those included in PCV20 and those not included in any vaccine. Serotype 19A was initially the most resistant and the 15A, not included in any vaccine, deserves special follow-up. Serotype 8, which increased the most, did not show remarkable resistance.

€ View funding

Funding information

Funders

Bibliographic References

  • Hausdorff, W.P., Feikin, D.R., Klugman, K.P., Epidemiological differences among pneumococcal serotypes. Lancet Infect Dis 5 (2005), 83–93, 10.1016/S1473-3099(05)01280-6.
  • Geno, K.A., Gilbert, G.L., Song, J.Y., Skovsted, I.C., Klugman, K.P., Jones, C., et al. Pneumococcal capsules and their types: past, present, and future. Clin Microbiol Rev 28 (2015), 871–899, 10.1128/CMR.00024-15.
  • Troeger, C., Blacker, B., Khalil, I.A., Rao, P.C., Cao, J., Zimsen, S.R.M., et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study. Lancet Infect Dis 18 (2018), 1191–1210, 10.1016/S1473-3099(18)30310-4.
  • Vacinación fronte ao pneumococo (estudo piloto) Instrucción. 2011. Vacinación pneumococo (estudo piloto)_2011 [consultado11 Ene 2023]. Disponible en: https://www.sergas.es/Saude-publica/Documents/2350/Instruci%C3%B3n%20pneumococo%20piloto%202011_galego.pdf.
  • Méndez-Lage, S., Losada-Castillo, I., Agulla-Budiño, A., Streptococcus pneumoniae: distribución de serotipos, sensibilidad antibiótica, factores de riesgo y mortalidad en Galicia en un periodo de 2 años. Enferm Infecc Microbiol Clin 33 (2015), 579–584, 10.1016/j.eimc.2015.01.010.
  • Vacinación antipneumocócica en adultos. Nota_informativa_vacinacion_antipneumococica_2017.pdf [consultado11 Ene 2023]. Disponible en: https://www.sergas.es/Saude-publica/Documents/4536/Nota_informativa_vacinacion_antipneumococica_2017.pdf.
  • Hanquet, G., Krizova, P., Dalby, T., Ladhani, S.N., Nuorti, J.P., Danis, K., et al. Serotype replacement after introduction of 10-valent and 13-valent pneumococcal conjugate veccines in 10 countries, Europe. Emerg Infect Dis 28 (2022), 127–138, 10.3201/eid2801.210734.
  • Càmara, J., Marimón, J.M., Cercenado, E., Larrosa, N., Quesada, M.D., Fontanals, D., et al. Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain. PLOS One, 12, 2017, e0175224, 10.1371/journal.pone.0175224.
  • Houseman, C., Hughes, G.J., Chapman, K.E., Wilson, D., Gorton, R., Increased invasive pneumococcal disease, North East England, UK. Emerg Infect Dis 23 (2017), 122–126, 10.3201/eid2301.160897.
  • Sheppard, C., Fry, N.K., Mushtaq, S., Woodford, N., Reynolds, R., Janes, R., et al. Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014. Eurosurveillance, 21, 2016, 10.2807/1560-7917.ES.2016.21.50.30423.
  • Porter, B.D., Ortika, B.D., Satzke, C., Capsular serotyping of Streptococcus pneumoniae by latex agglutination. J Vis Exp, 91, 2014, 51747, 10.3791/51747.
  • EUCAST: Clinical breakpoints and dosing of antibiotics [consultado11 Ene 2023]. Disponible en: https://www.eucast.org/clinical_breakpoints.
  • Buades, J., Losada, I., González-Moreno, J., Peñaranda, M., Vilaplana, L., Roda, N., et al. Evolution, clinical and microbiological characteristics of invasive pneumococcal disease since the introduction of the pneumococcal conjugate vaccine 13-valent in adults over 18 years old. Vaccines, 9, 2021, 93, 10.3390/vaccines9020093.
  • Silva-Costa, C., Gomes-Silva, J., Teodoro, I., Ramirez, M., Melo-Cristino, J., Invasive pneumococcal disease in adults in Portugal: The importance of serotypes 8 and 3 (2015–2018). Microorganisms, 9, 2021, 1016, 10.3390/microorganisms9051016.
  • Ladhani, S.N., Collins, S., Djennad, A., Sheppard, C.L., Borrow, R., Fry, N.K., et al. Rapid increase in non-vaccine serotypes causing invasive pneumococcal disease in England and Wales, 2000-17: A prospective national observational cohort study. Lancet Infect Dis 18 (2018), 441–451, 10.1016/S1473-3099(18)30052-5.
  • Nakano, S., Fujisawa, T., Ito, Y., Chang, B., Matsumura, Y., Yamamoto, M., et al. Nationwide surveillance of paediatric invasive and non-invasive pneumococcal disease in Japan after the introduction of the 13-valent conjugated vaccine, 2015-2017. Vaccine 38 (2020), 1818–1824, 10.1016/j.vaccine.2019.12.022.
  • Moore, M.R., Link-Gelles, R., Schaffner, W., Lynfield, R., Lexau, C., Bennett, N.M., et al. Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: Analysis of multisite, population-based surveillance. Lancet Infect Dis 15 (2015), 301–309, 10.1016/S1473-3099(14)71081-3.
  • Richter, S.S., Diekema, D.J., Heilmann, K.P., Dohrn, C.L., Riahi, F., Doern, G.V., Changes in pneumococcal serotypes and antimicrobial resistance after introduction of the 13-valent conjugate vaccine in the United States Antimicrob Agents Chemother 58 (2014), 6484–6489, 10.1128/AAC.03344-14.
  • Fernández-Delgado, L., Càmara, J., González-Díaz, A., Grau, I., Shoji, H., Tubau, F., et al. Serotypes in adult pneumococcal pneumonia in Spain in the era of conjugate vaccines. Microorganisms, 9, 2021, 2245, 10.3390/microorganisms9112245.
  • Deloria Knoll, M., Bennett, J., Garcia Quesada, M., Kagucia, E., Peterson, M., Feikin, D., et al. Global landscape review of serotype-specific invasive pneumococcal disease surveillance among countries using PCV10/13: The pneumococcal serotype replacement and distribution estimation (PSERENADE) project. Microorganisms, 9, 2021, 742, 10.3390/microorganisms9040742.
  • De Miguel, S., Domenech, M., González-Camacho, F., Sempere, J., Vicioso, D., Sanz, J.C., et al. Nationwide trends of invasive pneumococcal disease in Spain from 2009 through 2019 in children and adults during the pneumococcal conjugate vaccine era. Clin Infect Dis 73 (2021), e3778–e3787, 10.1093/cid/ciaa1483.
  • Sá-Leão, R., Pinto, F., Aguiar, S., Nunes, S., Carriço, J.A., Frazão, N., et al. Analysis of invasiveness of pneumococcal serotypes and clones circulating in Portugal before widespread use of conjugate vaccines reveals heterogeneous behavior of clones expressing the same serotype. J Clin Microbiol 49 (2011), 1369–1375, 10.1128/JCM.01763-10.
  • Brueggemann, A.B., Griffiths, D.T., Meats, E., Peto, T., Crook, D.W., Spratt, B.G., Clonal relationships between Invasive and carriage Streptococcus pneumoniae and serotype and clone specific differences in invasive disease potential. J Infect Dis 187 (2003), 1424–1432, 10.1086/374624.
  • Nakano, S., Fujisawa, T., Ito, Y., Chang, B., Matsumura, Y., Yamamoto, M., et al. Whole-genome sequencing analysis of multidrug-resistant serotype 15A Streptococcus pneumoniae in Japan and the emergence of a highly resistant serotype 15A-ST9084 clone. Antimicrob Agents Chemother 63 (2019), e02579–e2618, 10.1128/AAC.02579-18.