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Evolving pneumococcal serotypes and sequence types in relation to high antibiotic stress and conditional pneumococcal

Lin-Hui Su1,2,3, An-Jing Kuo1,2, Ju-Hsin Chia1,2

  • 1Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.

Scientific Reports
|November 3, 2015
PubMed

Insights

Pneumococcal conjugate vaccine (PCV13) immunization in Taiwan reduced disease incidence in all age groups. However, the emergence of non-PCV13 serotypes, particularly in the elderly, warrants further investigation and potential vaccine strategy adjustments.

Area of Science:

  • Infectious Diseases
  • Vaccinology
  • Epidemiology

Background:

  • Taiwan introduced free 13-valent pneumococcal conjugate vaccine (PCV13) for children in 2013, expanding coverage in 2014.
  • Pneumococcal disease remains a significant public health concern globally, necessitating effective vaccination strategies.

Purpose of the Study:

  • To evaluate the impact of PCV13 introduction on pneumococcal disease incidence in Taiwan.
  • To assess changes in serotype distribution and antimicrobial resistance patterns post-PCV13 implementation.

Main Methods:

  • Prospective surveillance of 953 culture-confirmed pneumococcal disease (CCPD) cases, including 104 invasive pneumococcal disease (IPD) cases, from 2012-2014.
  • Analysis of serotype distribution, including PCV13 and non-PCV13 serotypes, and penicillin minimum inhibitory concentrations (MICs).

Main Results:

  • A significant decrease in CCPD (26.7 to 20.4 per 10,000 admissions) and IPD (3.2 to 1.9 per 10,000 admissions) was observed.
  • PCV13 serotype reduction was noted in children (2013) and extended to all ages (2014), but non-PCV13 serotypes (15A, 15B, 23A) increased (6.1 to 9.3 per 10,000 admissions).
  • Penicillin resistance decreased significantly (27.8% to 8.1%), but PCV13 immunization's protective effect was diminished in the elderly due to non-PCV13 serotype emergence.

Conclusions:

  • PCV13 immunization in young children provided early protection across all age groups in Taiwan.
  • The emergence of non-PCV13 serotypes, particularly in the elderly, highlights the need for ongoing surveillance and potentially broader-spectrum vaccines.

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