scholarly journals Noninvasive Streptococcus pneumoniae Serotypes Recovered from Hospitalized Adult Patients in the United States in 2009 to 2012

2015 ◽  
Vol 59 (9) ◽  
pp. 5595-5601 ◽  
Author(s):  
Rodrigo E. Mendes ◽  
Rosalind C. Hollingsworth ◽  
Andrew Costello ◽  
Ronald N. Jones ◽  
Raul E. Isturiz ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Respiratory Infections ◽  
Adult Population ◽  
The United States ◽  
Adult Patients ◽  
Content Type ◽  
Trends Over Time

ABSTRACTThis study was conducted to determine the serotype distribution and trends over time ofStreptococcus pneumoniaestrains associated with noninvasive infections among adult patients ≥18 years of age in the United States (2009 to 2012). A total of 2,927S. pneumoniaeisolates recovered from patients presenting with respiratory infections and obtained mainly (87.0%) from lower respiratory tract specimens (sputum) were included. The levels of the 7-valent pneumococcal conjugate vaccine (PCV7) serotypes remained stable over the 4-year study period (4.6% to 5.5%;P= 0.953). Overall, 13-valent pneumococcal conjugate vaccine (PCV13) serotypes were identified in 32.7% of samples, declining from 33.7% to 35.5% in 2009 to 2011 to 28.2% in 2012 (P= 0.007), with a significant decrease in the levels of serotypes 7F (P= 0.013) and 6A (P= 0.010). The levels of 19A remained constant (15.8% to 17.1%) during 2009 to 2011, dropping to 12.2% in 2012 (P= 0.089). The prevalence of serotypes associated with the 23-valent pneumococcal polysaccharide vaccine (PPSV23), but not PCV13, remained generally stable; however, the prevalence of serotypes 15B and 15C (15B/15C) increased from 2.7% to 6.3% (P= 0.010). The proportion of nonvaccine serotypes increased gradually during the study period (P= 0.044), particularly for serotype 35B (from 3.6% in 2009 to 8.2% in 2012;P= 0.001). Nonsusceptibility rates for penicillin (susceptible breakpoint, ≤2 μg/ml) and clindamycin against PCV7 serotypes decreased over the period. These results suggest the emergence of indirect effects following introduction of PCV13 for infants and young children; continued surveillance is needed to assess the burden of PCV13 serotypes in the adult population after the implementation of age-based recommendations in the United States.

scholarly journals Invasive and Noninvasive Streptococcus pneumoniae Capsule and Surface Protein Diversity following the Use of a Conjugate Vaccine

2013 ◽  
Vol 20 (11) ◽  
pp. 1711-1718 ◽  
Author(s):  
Christina M. Croney ◽  
Moon H. Nahm ◽  
Steven K. Juhn ◽  
David E. Briles ◽  
Marilyn J. Crain
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Vaccine Development ◽  
Surface Protein ◽  
The United States ◽  
Protein Diversity ◽  
Potential Efficacy

ABSTRACTThe 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the United States in 2010 for the prevention of invasive pneumococcal disease (IPD) and otitis media. While many studies have reported its potential efficacy for IPD, not much is known about the epidemiology of noninvasive disease following its introduction. We characterized the capsular types and surface protein genes of noninvasive pediatric pneumococcal isolates collected between 2002 and 2010 (n= 1,058) at Children's of Alabama following the introduction of PCV7 and tested a subset of noninvasive and previously characterized IPD isolates for the presence of thepspA,pspC, andrrgCgenes, which encode protection-eliciting proteins. PCV7 serotypes had dramatically decreased by 2010 (P< 0.0001), and only 50% of all noninvasive infections were caused by the PCV13 capsular serotypes. Serotype 19A accounted for 32% of the noninvasive isolates, followed by serotypes 35B (9%), 19F (7%), and 6C (6%). After 7 years of PCV7 usage, there were no changes in the frequencies of thepspAorpspCgenes; 96% of the strains were positive for family 1 or 2pspAgenes, and 81% were also positive forpspC. Unexpectedly, more noninvasive than invasive strains were positive forrrgC(P< 0.0001), and the proportion ofrrgC-positive strains in 2008 to 2010 was greater than that in 2002 to 2008 (IPD,P< 0.02; noninvasive,P< 0.001). Serotypes 19F, 19A, and 35B were more frequentlyrrgCpositive (P< 0.005) than other serotypes. A vaccine containing antigens, such as PspA, PspC, and/or RrgC, can provide coverage against most non-PCV13-type pneumococci. Continued surveillance is critical for optimal future vaccine development.

scholarly journals 78Pneumococcal Meningitis among 8 Children's Hospitals in the United States in the 13-valent Pneumococcal Conjugate Vaccine Era

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S2-S3
Author(s):  
Liset Olarte ◽  
William J. Barson ◽  
Philana Ling Lin ◽  
Jose Romero ◽  
Tina Tan ◽  
...  
Keyword(s):  
United States ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
The United States ◽  
Children's Hospitals ◽  
Children’S Hospitals

scholarly journals Impact of Pneumococcal Conjugate Vaccination of Infants on Pneumonia and Influenza Hospitalization and Mortality in All Age Groups in the United States

mBio ◽  
2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Lone Simonsen ◽  
Robert J. Taylor ◽  
Yinong Young-Xu ◽  
Michael Haber ◽  
Larissa May ◽  
...  
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Pneumococcal Pneumonia ◽  
Herd Immunity ◽  
Age Groups ◽  
The United States ◽  
Conjugate Vaccination

ABSTRACT A seven-valent pneumococcal conjugate vaccine (PCV7) introduced in the United States in 2000 has been shown to reduce invasive pneumococcal disease (IPD) in both vaccinated children and adults through induction of herd immunity. We assessed the impact of infant immunization on pneumococcal pneumonia hospitalizations and mortality in all age groups using Health Care Utilization Project State Inpatient Databases (SID) for 1996 to 2006 from 10 states; SID contain 100% samples of ICD9-coded hospitalization data for the selected states. Compared to a 1996–1997 through 1998–1999 baseline, by the 2005–2006 season, both IPD and pneumococcal pneumonia hospitalizations and deaths had decreased substantially in all age groups, including a 47% (95% confidence interval [CI], 38 to 54%) reduction in nonbacteremic pneumococcal pneumonia (ICD9 code 481 with no codes indicating IPD) in infants <2 years old and a 54% reduction (CI, 53 to 56%) in adults ≥65 years of age. A model developed to calculate the total burden of pneumococcal pneumonia prevented by infant PCV7 vaccination in the United States from 2000 to 2006 estimated a reduction of 788,838 (CI, 695,406 to 875,476) hospitalizations for pneumococcal pneumonia. Ninety percent of the reduction in model-attributed pneumococcal pneumonia hospitalizations occurred through herd immunity among adults 18 years old and older; similar proportions were found in pneumococcal disease mortality prevented by the vaccine. In the first seasons after PCV introduction, when there were substantial state differences in coverage among <5-year-olds, states with greater coverage had significantly fewer influenza-associated pneumonia hospitalizations among children, suggesting that PCV7 use also reduces influenza-attributable pneumonia hospitalizations. IMPORTANCE Pneumonia is the world’s leading cause of death in children and the leading infectious cause of death among U.S. adults 65 years old and older. Pneumococcal conjugate vaccination of infants has previously been shown to reduce invasive pneumococcal disease (IPD) among seniors through prevention of pneumococcal transmission from infants to adults (herd immunity). Our analysis documents a significant vaccine-associated reduction not only in IPD but also in pneumococcal pneumonia hospitalizations and inpatient mortality rates among both vaccinated children and unvaccinated adults. We estimate that fully 90% of the reduction in the pneumonia hospitalization burden occurred among adults. Moreover, states that more rapidly introduced their infant pneumococcal immunization programs had greater reductions in influenza-associated pneumonia hospitalization of children, presumably because the vaccine acts to prevent the pneumococcal pneumonia that frequently follows influenza virus infection. Our results indicate that seven-valent pneumococcal conjugate vaccine use has yielded far greater benefits through herd immunity than have previously been recognized.

Streptococcus pneumoniae: An Update on Resistance Patterns in the United States

2008 ◽  
Vol 21 (5) ◽  
pp. 363-370 ◽  
Author(s):  
Jessica A. Starr ◽  
Georgia W. Fox ◽  
Jennifer K. Clayton
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Agents ◽  
Respiratory Infections ◽  
Tetracycline Resistance ◽  
The United States ◽  
Multidrug Resistant ◽  
Beta Lactam ◽  
Resistance Patterns ◽  
Surveillance Programs

Streptococcus pneumoniae represents an important pathogen in numerous community-acquired respiratory infections. Penicillin resistance to Streptococcus pneumoniae in the United States has approached 35%. Additionally, there has been a significant increase in Streptococcus pneumoniae resistance among many other antimicrobial agents such as cephalosporins, macrolides, trimethoprim–sulfamethoxazole, clindamycin, tetracyclines, and chloramphenicol. Several nationwide surveillance programs have been implemented to quantify the prevalence of Streptococcus pneumoniae resistance in the United States. Overall, beta-lactam, macrolide, trimethoprim–sulfamethoxazole, and tetracycline resistance has increased over the past decade while later generation fluoroquinolones (levofloxacin and moxifloxacin) resistance has remained low. Controlling the spread of resistant pneumococcal isolates and preventing the development of both fluoroquinolone and multidrug resistant isolates will require a multidisciplinary approach involving physicians, pharmacists, microbiologists, and epidemiologists.

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