scholarly journals Subcutaneous abscess caused by Streptococcus pneumoniae serotype 28F in an infant: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomohiro Hirade ◽  
Ai Harada ◽  
Daisuke Koike ◽  
Yasuhiro Abe ◽  
Tsuyoshi Higuchi ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Incision And Drainage ◽  
Case Presentation ◽  
Vaccine Serotypes ◽  
Global Issue ◽  
Serotype Replacement ◽  
Pneumococcal Serotype ◽  
Sterile Site ◽  
International Data ◽  
Highly Virulent

Abstract Background Invasive pneumococcal disease (IPD) is defined by the detection of Streptococcus pneumoniae on culture from samples obtained from a normally sterile site. Pneumococcal conjugate vaccines (PCV) have been developed for the prevention of IPD that is caused by highly virulent serotypes. Despite the effective reduction of IPD caused by vaccine serotypes after the introduction of PCV, there has been a rapid increase in the incidence of IPD caused by non-vaccine serotypes, and serotype replacement has become a global issue. Case presentation We report a previously healthy 4-month-old girl presenting with a large subcutaneous abscess caused by S. pneumoniae, identified as non-vaccine serotype 28F. The patient had received routine vaccination, including PCV vaccination. After the incision and drainage of the subcutaneous abscess, the patient was treated with antibiotics. She was discharged on Day 7 of hospitalization without any residual sequelae. Conclusions Subcutaneous abscess is a common pediatric skin and soft tissue infection, whereas pneumococcal subcutaneous abscesses are quite rare. As the pneumococcal serotype 28F caused a subcutaneous abscess, this serotype possibly has a high virulence. The incidence of IPD caused by non-vaccine serotypes, such as 28F, is expected to increase in the future. The consolidation of international data on pneumococcal serotypes is important for the development of novel PCV.

scholarly journals Evaluating post-vaccine expansion patterns of pneumococcal serotypes

2020 ◽  
Author(s):  
Maile T. Phillips ◽  
Joshua L. Warren ◽  
Noga Givon-Lavi ◽  
Adrienn Tothpal ◽  
Gili Regev-Yochay ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Jewish Population ◽  
Pneumococcal Disease ◽  
Pneumococcal Serotypes ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
Disease Understanding

ABSTRACTStreptococcus pneumoniae remains a leading cause of morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) are effective but target only a fraction of the more than 90 pneumococcal serotypes. As a result, the introduction of PCVs has been followed by the emergence of non-vaccine serotypes. With higher-valency PCVs currently under development, there is a need to understand and predict patterns of serotype replacement to anticipate future changes. In this study, we evaluated patterns of change in serotype prevalence post-PCV introduction in Israel. We found that the assumption that non-vaccine serotypes increase by the same proportion overestimates changes in serotype prevalence in Jewish and Bedouin children. Furthermore, pre-vaccine prevalence was positively associated with increases in prevalence over the study period. From our analyses, serotypes 12F, 8, 16F, 33F, 9N, 7B, 10A, 22F, 24F, and 17F were estimated to have gained the most cases of invasive pneumococcal disease through serotype replacement in the Jewish population. However, this model also failed to quantify some additional cases gained, suggesting that changes in carriage in children alone may be insufficient to explain serotype replacement in disease. Understanding of serotype replacement is important as higher-valency vaccines are introduced.

scholarly journals Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project

2021 ◽  
Vol 9 (4) ◽  
pp. 696 ◽  
Author(s):  
Julia Bennett ◽  
Marissa Hetrich ◽  
Maria Garcia Quesada ◽  
Jenna Sinkevitch ◽  
Maria Deloria Knoll ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Incidence Rate ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Mixed Effects ◽  
Data Availability ◽  
Serotype Replacement ◽  
Serotype 1 ◽  
Pneumococcal Serotype ◽  
Rate Ratios

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3 + 0 schedule constrains generalizability and data from these settings are needed.

scholarly journals Differences in Pneumococcal Serotype Replacement in Individuals with and without Underlying Medical Conditions

2018 ◽  
Author(s):  
Daniel M. Weinberger ◽  
Joshua L Warren ◽  
Tine Dalby ◽  
Eugene D. Shapiro ◽  
Valentiner Branth ◽  
...  
Keyword(s):  
Age Groups ◽  
Risk Groups ◽  
Bayesian Regression ◽  
Childhood Vaccination ◽  
Conjugate Vaccines ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
Pneumococcal Serotype ◽  
Nationwide Surveillance ◽  
The Impact

ABSTRACTBackgroundPneumococcal conjugate vaccines (PCVs) have had a well-documented impact on the incidence of invasive pneumococcal disease (IPD) worldwide. However, declines in IPD due to vaccine-targeted serotypes have been partially offset by increases in IPD due to non-vaccine serotypes. The goal of this study was to quantify serotype-specific changes in the incidence of IPD that occurred in different age groups, with or without certain co-morbidities, following the introduction of PCV7 and PCV13 in the childhood vaccination program in Denmark.MethodsWe used nationwide surveillance data for IPD in Denmark and a hierarchical Bayesian regression framework to estimate changes in the incidence of IPD associated with the introduction of PCV7 (2007) and PCV13 (2010) while controlling for serotype-specific epidemic cycles and unrelated secular trends.Results and ConclusionsFollowing the introduction of PCV7 and 13 in children, the net impact of serotype replacement varied considerably by age group and the presence of comorbid conditions. Serotype replacement offset a greater fraction of the decline in vaccine-targeted serotypes following the introduction of PCV7 compared with the period following the introduction of PCV13. Differences in the magnitude of serotype replacement were due to variations in the incidence of non-vaccine serotypes in the different risk groups before the introduction of PCV7 and PCV13. The relative increases in the incidence of IPD caused by non-vaccine serotypes did not differ appreciably in the post-vaccination period. Serotype replacement offset a greater proportion of the benefit of PCVs in strata in which the non-vaccine serotypes comprised a larger proportion of cases prior to the introduction of the vaccines. These findings could help to predict the impact of next-generation conjugate vaccines in specific risk groups.

scholarly journals 2714. Streptococcus pneumoniae Nasopharyngeal Carriage in Canadian Adults Hospitalized with Community-Acquired Pneumonia from 2010 to 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S954-S955
Author(s):  
Jason J LeBlanc ◽  
May ElSherif ◽  
Amanda L S Lang ◽  
Hayley D Gillis ◽  
Lingyun Ye ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Real Time ◽  
Herd Immunity ◽  
Community Acquired Pneumonia ◽  
Serotype Distribution ◽  
Childhood Immunization ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
The Impact ◽  
Over Time

Abstract Background Streptococcus pneumoniae can colonizes the human nasopharynx, and can cause life-threatening infections like community-acquired pneumonia (CAP) and invasive pneumococcal diseases (IPD). In Canada, the 13-valent conjugate vaccine (PCV13) was introduced in childhood immunization since 2010, with hopes that it would not only protect the vaccinated, but also confer indirect protection to adults through herd immunity. Given data on S. pneumoniae nasopharyngeal (NP) carriage in adults is scarce, this study reports on S. pneumoniae-positivity and serotype distribution in adult carriage from years 2010 to 2017. Methods Active surveillance was performed in adults hospitalized with for CAP or IPD from December 2010 to 2017. For assessment of S. pneumoniae carriage, NP swabs were tested using lytA and cpsA real-time PCR. S. pneumoniae-positive NPs were subjected to serotyping using conventional and real-time multiplex PCRs. Results Overall, 6472 NP swabs were tested, and Spn was identified in 366 (5.7%). Of the 366 S. pneumoniae-positive NP swabs, a serotype was assigned in 355 (97.0%). From years 2010 to 2017, the proportion of S. pneumoniae-positive NP swabs declined from 8.9% to 4.3%. This was also reflected in the proportion of serotypeable results attributed to PCV13 serotypes, which also declined from 76.9% to 42.2%. The decline was primarily attributed to PCV13 serotypes 7F and 19A. PCV13 serotype 3 remained predominant throughout the study, as did non-PCV13 serotypes like 22F, 33F, and 11A. On the other hand, a proportional rise over time was noted for non-vaccine serotypes (from 15.4% to 31.1%). This was primarily attributed to serotypes 23A, 15A, and 35B. Conclusion Monitoring serotype trends is important to assess the impact of pneumococcal vaccines. While herd immunity from PCV13 childhood immunization was anticipated, few studies have assessed its impact on adult carriage. This study described Spn serotype distribution in adults over years 2010 to 2017, demonstrating not only a reduction of PCV13 serotypes over time, but a proportional rise in non-vaccine serotypes. These emerging serotypes may represent the emergence of serotype replacement. Ongoing serotype surveillance will be needed to compare S. pneumoniae carriage to serotypes associated with pneumococcal CAP and IPD. Disclosures All authors: No reported disclosures.

scholarly journals Local outbreak of Streptococcus pneumoniae serotype 12F caused high morbidity and mortality among children and adults

2018 ◽  
Vol 146 (14) ◽  
pp. 1793-1796 ◽  
Author(s):  
T. Ikuse ◽  
R. Habuka ◽  
Y. Wakamatsu ◽  
T. Nakajima ◽  
N. Saitoh ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Continuous Monitoring ◽  
Close Contact ◽  
Control Strategies ◽  
High Morbidity ◽  
Transmission Route ◽  
Pneumococcal Serotypes ◽  
Serotype Replacement ◽  
Pneumococcal Serotype

AbstractPneumococcal serotype replacement is an important issue after the introduction of pneumococcal conjugate vaccine (PCV) in children. After the introduction of 13-valent PCV, the incidence of invasive pneumococcal diseases (IPD) caused by Streptococcus pneumoniae serotype 12F (Sp12F) have increased in some countries; however, an outbreak of Sp12F has not reported in the post-13-valent PCV era. We experienced a local outbreak of Sp12F during March through May 2016 in Tsuruoka city, Japan after the introduction of 13-valent PCV in 2013. The IPD patients were two children and seven adults, three of whom died with a rapid disease progress. Although the clear transmission route was not determined, eight of the nine patients (89%) had close contact with children, which suggests that transmitted colonisation of Sp12F among children and adults might be the source of transmission. Continuous monitoring of IPDs, along with the determination of pneumococcal serotypes, is warranted in the post–13-valent PCV era. New IPD control strategies may be needed if this fatal outbreak continues to occur.

scholarly journals Urgent surgery for COVID-19–positive pediatric patient

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Franchesca Rivera-Calonje ◽  
Shiu-Yi Emily Chen ◽  
Carl Lo ◽  
Sang Le ◽  
Makoto Nagoshi
Keyword(s):  
Spinal Anesthesia ◽  
Pediatric Patient ◽  
Healthcare Providers ◽  
Safe Alternative ◽  
Incision And Drainage ◽  
Case Presentation ◽  
Urgent Surgery ◽  
Intervention Patient ◽  
Lateral Decubitus ◽  
Endotracheal Anesthesia

Abstract Background We present a case of COVID-19–positive pediatric patient for urgent urological surgery by spinal anesthesia to avoid aerosolizing procedure. Case presentation A 12-year-old, COVID-19–positive boy presented for urgent wound incision and drainage at the circumcision site. Our anesthetic plan consisted of spinal anesthesia with sedation. He was transported from the COVID-19 isolation floor to the negative pressure operating room. He was placed in lateral decubitus position and oxygen was delivered through facemask. Under sedation, spinal anesthesia was achieved at first attempt. The patient maintained spontaneous ventilation without airway intervention. Patient was recovered in the operation room then transported back to the floor. Conclusion Spinal anesthesia is a safe alternative to general endotracheal anesthesia for many pediatric urology procedures. Effective team communication and preparation are keys when caring COVID-19–positive patient in perioperative setting to avoid minimize the risk to healthcare providers.

scholarly journals Genetic Relatedness of the Streptococcus pneumoniae Capsular Biosynthetic Loci

2007 ◽  
Vol 189 (21) ◽  
pp. 7841-7855 ◽  
Author(s):  
Angeliki Mavroidi ◽  
David M. Aanensen ◽  
Daniel Godoy ◽  
Ian C. Skovsted ◽  
Margit S. Kaltoft ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Genetic Relatedness ◽  
Pneumococcal Serotypes ◽  
Major Cluster ◽  
Genes Encoding ◽  
Pneumococcal Serotype ◽  
Streptococcal Polysaccharide ◽  
Single Cluster ◽  
Dependent Pathway ◽  
Sequence Similarities

ABSTRACT Streptococcus pneumoniae (the pneumococcus) produces 1 of 91 capsular polysaccharides (CPS) that define the serotype. The cps loci of 88 pneumococcal serotypes whose CPS is synthesized by the Wzy-dependent pathway were compared with each other and with additional streptococcal polysaccharide biosynthetic loci and were clustered according to the proportion of shared homology groups (HGs), weighted for the sequence similarities between the genes encoding the shared HGs. The cps loci of the 88 pneumococcal serotypes were distributed into eight major clusters and 21 subclusters. All serotypes within the same serogroup fell into the same major cluster, but in six cases, serotypes within the same serogroup were in different subclusters and, conversely, nine subclusters included completely different serotypes. The closely related cps loci within a subcluster were compared to the known CPS structures to relate gene content to structure. The Streptococcus oralis and Streptococcus mitis polysaccharide biosynthetic loci clustered within the pneumococcal cps loci and were in a subcluster that also included the cps locus of pneumococcal serotype 21, whereas the Streptococcus agalactiae cps loci formed a single cluster that was not closely related to any of the pneumococcal cps clusters.

scholarly journals Differences in the Impact of Pneumococcal Serotype Replacement in Individuals With and Without Underlying Medical Conditions

2018 ◽  
Vol 69 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Daniel M Weinberger ◽  
Joshua L Warren ◽  
Tine Dalby ◽  
Eugene D Shapiro ◽  
Palle Valentiner-Branth ◽  
...  
Keyword(s):  
Medical Conditions ◽  
Serotype Replacement ◽  
Pneumococcal Serotype ◽  
The Impact

scholarly journals Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

2004 ◽  
Vol 48 (9) ◽  
pp. 3491-3497 ◽  
Author(s):  
Mathias W. R. Pletz ◽  
Lesley McGee ◽  
James Jorgensen ◽  
Bernard Beall ◽  
Richard R. Facklam ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
The United States ◽  
Fluoroquinolone Resistance ◽  
Active Efflux ◽  
Vaccine Serotypes ◽  
Drug Classes ◽  
Control And Prevention ◽  
Clonal Spread ◽  
The Impact

ABSTRACT The emergence of fluoroquinolone resistance in sterile-site isolates of Streptococcus pneumoniae is documented in this study characterizing all invasive levofloxacin-resistant (MIC, ≥8 mg/liter) S. pneumoniae isolates (n = 50) obtained from the Centers for Disease Control and Prevention Active Bacterial Core Surveillance from 1998 to 2002. Resistance among all isolates increased from 0.1% in 1998 to 0.6% in 2001 (P = 0.008) but decreased to 0.4% in 2002, while resistance among vaccine serotypes continued to increase from 0.3% in 1998 to 1.0% in 2002, suggesting that fluoroquinolones continue to exert selective pressure on these vaccine serotypes. Only 22% of resistant isolates were not covered by the conjugate vaccine serogroups. Multilocus sequence typing revealed that 58% of resistant strains were related to five international clones identified by the Pneumococcal Molecular Epidemiology Network, with the Spain23F-1 clone being most frequent (16% of all isolates). Thirty-six percent of the isolates were coresistant to penicillin, 44% were coresistant to macrolides, and 28% were multiresistant to penicillin, macrolides, and fluoroquinolones. Fifty percent of the isolates were resistant to any three drug classes. Ninety-four percent of the isolates had multiple mutations in the quinolone resistance-determining regions of the gyrA, gyrB, parC, and parE genes. In 16% of the isolates, there was evidence of an active efflux mechanism. An unusual isolate was found that showed only a single parE mutation and for which the ciprofloxacin MIC was lower (2 mg/liter) than that of levofloxacin (8 mg/liter). Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread.

scholarly journals Divergent serotype replacement trends and increasing diversity in pneumococcal disease in high income settings reduce the benefit of expanding vaccine valency

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alessandra Løchen ◽  
Nicholas J. Croucher ◽  
Roy M. Anderson
Keyword(s):  
Pneumococcal Disease ◽  
Vaccine Uptake ◽  
Partial Replacement ◽  
Age Group ◽  
Serotype Distribution ◽  
Post Vaccination ◽  
Vaccine Serotypes ◽  
European North ◽  
Serotype Replacement ◽  
The Impact

Abstract Streptococcus pneumoniae is a significant cause of otitis media, pneumonia, and meningitis. Only seven of the approximately 100 serotypes were initially included in the pneumococcal polysaccharide conjugate vaccine (PCV) in 2000 before it was expanded in subsequent years. Although the invasive pneumococcal disease (IPD) incidence due to vaccine serotypes (VT) has declined, partial replacement by non-vaccine serotypes (NVT) was observed following widespread vaccine uptake. We conducted a trend analysis assembling the available evidence for PCV impact on European, North American and Australian national IPD. Significant effectiveness against VT IPD in infants was observed, although the impact on national IPD incidence varied internationally due to serotype replacement. Currently, NVT serotypes 8, 9N, 15A and 23B are increasing in the countries assessed, although a variety of other NVTs are affecting each country and age group. Despite these common emerging serotypes, there has not been a dominant IPD serotype post-vaccination as there was pre-vaccination (serotype 14) or post-PCV7 (serotype 19A), suggesting that future vaccines with additional serotypes will be less effective at targeting and reducing IPD in global populations than previous PCVs. The rise of diverse NVTs in all settings’ top-ranked IPD-causing serotypes emphasizes the urgent need for surveillance data on serotype distribution and serotype-specific invasiveness post-vaccination to facilitate decision making concerning both expanding current vaccination programmes and increasing vaccine valency.

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