Resilience and emergence of pneumococcal serotypes and lineages in adults post-PCV13 in Spain: A multicentre study.
Autor: | Calvo-Silveria S; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain., González-Díaz A; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain. Electronic address: agonzalezd@bellvitgehospital.cat., Marimón JM; Biogipuzkoa, Infectious Diseases Area, Infectious Epidemiology and Antimicrobial Resistance Group, Osakidetza Basque Health Service, Microbiology Department, Hospital Donostia, Donostia-San Sebastian, Spain., Cercenado E; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Clinical Microbiology and Infectious Disease Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Quesada MD; Microbiology Department, Clinical Laboratory North Metropolitan Area, Hospital Universitari Germans Trias i Pujol, UAB, Badalona, Spain., Casabella A; Laboratory of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain; Institut d'Investigació I Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain., Larrosa N; Microbiology Department, Hospital Universitari Vall d'Hebron, UAB, Barcelona, Spain; Research Network for Infectious Diseases (CIBERINFEC), ISCIII, Madrid, Spain., Berbel D; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain., Alonso M; Biogipuzkoa, Infectious Diseases Area, Infectious Epidemiology and Antimicrobial Resistance Group, Osakidetza Basque Health Service, Microbiology Department, Hospital Donostia, Donostia-San Sebastian, Spain., Bernat-Sole M; Microbiology Department, Hospital Universitari Vall d'Hebron, UAB, Barcelona, Spain., Saiz-Escobedo L; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain., Yuste J; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Spanish Pneumococcal Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain., Martí S; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Spain., Càmara J; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain., Ardanuy C; Microbiology department, Hospital Universitari de Bellvitge - IDIBELL-UB, L'Hospitalet de Llobregat, Spain; Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain; Department of Pathology and Experimental Therapeutics, University of Barcelona, Spain. Electronic address: c.ardanuy@bellvitgehospital.cat. |
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Jazyk: | angličtina |
Zdroj: | Journal of infection and public health [J Infect Public Health] 2025 Jan; Vol. 18 (1), pp. 102619. Date of Electronic Publication: 2024 Dec 06. |
DOI: | 10.1016/j.jiph.2024.102619 |
Abstrakt: | Background: Streptococcus pneumoniae causes invasive pneumococcal disease (IPD) in adults. The introduction of pneumococcal conjugate vaccines (PCVs) has reduced vaccine serotypes but has also led to the rise of non-vaccine serotypes. The aim of this study was to analyse pneumococcal lineages and their association with recent changes in IPD among adults in Spain. Methods: Data from adult IPD cases (≥18 years) were collected from six Spanish hospitals in 2019-2021. Strains were serotyped, tested for antibiotic susceptibility and subjected to whole genome sequencing (WGS). Findings were compared with data from previous periods (2008-2016). Results: A total of 655 IPD episodes were examined. Pneumonia was the main focus (515/655), and 366 episodes occurred in adults over 64 years. Although IPD incidence decreased during COVID-19 pandemic, the burden of disease caused by PCV13 serotypes was significant. Notably, serotype 3 persisted (GPSC12-ST180 and GPSC83-ST260), and a new serotype 4 lineage emerged (GPSC162-ST13022). Among non-PCV13 serotypes, serotype 8 expanded (GPSC3-ST53) and a new serotype 12F lineage emerged (GPSC55-ST8060). Most serotypes presented a dominant Global Pneumococcal Sequencing Cluster (GPSC) like GPSC16-ST67 of 9N or GPSC19-ST433 of 22F. Nevertheless, some GPSCs were associated with several serotypes, the most numerous were GPSC3 (serotypes 8, 11A, and 33F) and GPSC6 (serotypes 11A and 14). The overall penicillin non-susceptibility rate was 17.0 %, 14.6 % resistance for meningitis and 1.6 % for pneumonia (15.1 % susceptible at increased exposure [SIE]). Serotypes 11A and 14 (GPSC6-ST156/6521) and 19A (GPSC1-ST320) had penicillin MICs above 1 mg/L. Acquired resistance genes associated with macrolide and/or tetracycline resistance were present in 19.4 % of isolates, particularly among serotypes 6C (GPSC47-ST386/4310) and 19A (GPSC1-ST320). Conclusions: The burden of PCV13 serotypes in adult IPD remains significant, and serotype 3 is the primary contributor. However, the rise of stable lineages associated with non-PCV13 serotypes, particularly 8, 9N, and 22F highlights a shifting epidemiology. The persistence of multidrug-resistant lineages, such as GPSC6-ST156 and GPSC1-ST320, emphasizes the need for continued surveillance. Vaccination of high-risk adults with current and broader coverage PCVs would help to control the burden of pneumonia and IPD among adults. Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sara Calvo-Silveria declares that the Project was partially funded by PFIS predoctoral grant number FI22/00279. José Yuste declares grants or contracts paid to his institution from MSD, Pfizer and Meiji. Support for attending meetings and/or travel from MSD and Pfizer. Participation on a Data Safety Monitoring Board or Advisory Board from GSK, MSD and Pfizer. Carmen Ardanuy declares funding to the institution from Instituto de Salud Carlos III through PI18/0339; PI21/1000 and INT22/0096; CB06/06/0037. Grants or contracts paid to her institution from MSD, Pfizer and Menarini. Payment or honoraria for lectures, or educational events from MSD and Pfizer to her o her institution. Support for attending meetings and/or travel from MSD and Pfizer. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.) |
Databáze: | MEDLINE |
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