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Pneumococcal population in the era of vaccination: changes in composition and the relation to clinical outcomes

Karin E Elberse1, Gertjan H J Wagenvoort2, Gerlinde N Pluister1

  • 1Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health & the Environment (RIVM), Bilthoven, The Netherlands.

Future Microbiology
|December 18, 2015
PubMed

Insights

Pneumococcal conjugate vaccines (PCV) alter bacterial populations. PCV7 introduction led to significant shifts in clonal lineages, particularly for serotype 12F, which was linked to increased pneumonia cases.

Area of Science:

  • Microbiology
  • Epidemiology
  • Vaccinology

Background:

  • Infant vaccination with pneumococcal conjugate vaccines (PCV) has significantly altered the prevalence of circulating pneumococcal serotypes.
  • Understanding these shifts is crucial for managing pneumococcal disease burden.

Purpose of the Study:

  • To evaluate the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) on the clonal structure of Streptococcus pneumoniae populations.
  • To determine the association between specific clonal lineages and clinical outcomes post-PCV7 introduction.

Main Methods:

  • Multiple-locus variable number tandem repeat (MLVA) analysis was employed to genotype pneumococcal isolates.
  • Pneumococcal populations were assessed before PCV7 introduction and at two time points after its implementation in The Netherlands.
  • Large sample sizes (n=1154, n=1190, n=1244) were analyzed across the different time periods.

Main Results:

  • Statistically significant shifts in clonal lineages were observed within serotypes 1 and 12F following PCV7 implementation.
  • An increasing clonal lineage within serotype 12F showed a significant association with pneumonia.
  • These findings highlight dynamic changes in the pneumococcal population structure.

Conclusions:

  • Changes in clonal lineages within pneumococcal serotypes can influence disease outcomes.
  • These shifts may represent the emergence of new variants or the filling of ecological niches vacated by vaccine serotypes.
  • Continued surveillance of clonal composition is essential for understanding and combating pneumococcal disease.
Abstract

Keywords:
MLVAStreptococcus pneumoniaecapsular switchingclinical outcomesepidemiologyinvasive pneumococcal diseasemolecular typingpneumococcal conjugate vaccine

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