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Molecular epidemiology of paediatric invasive pneumococcal disease in Andalusia, Spain

Beatriz de Felipe1, Pablo Obando Pacheco2, Begoña Carazo Gallego3

  • 1Biomedical Institute of Seville (IBiS), University of Seville, University Hospital Virgen del Rocío (HUVR)/CSIC, Seville, Spain.

Epidemiology and Infection
|August 22, 2022
PubMed

Insights

The pneumococcal conjugate vaccine 13 (PCV13) significantly reduced invasive pneumococcal disease (IPD) cases caused by PCV13 serotypes in Andalusian children. Non-vaccine serotypes 24F and 11A require monitoring due to their invasive potential and antibiotic resistance.

Area of Science:

  • * Infectious Disease Epidemiology
  • * Vaccinology
  • * Molecular Microbiology

Background:

  • * Invasive pneumococcal disease (IPD) remains a significant public health concern globally.
  • * The introduction of pneumococcal conjugate vaccines has altered the epidemiology of IPD.
  • * Understanding the impact of PCV13 on serotype distribution and antimicrobial resistance is crucial for public health strategies.

Purpose of the Study:

  • * To evaluate the effect of the pneumococcal conjugate vaccine 13 (PCV13) on the molecular epidemiology of IPD in children in Andalusia, Spain.
  • * To compare serotype and genotype distribution of IPD before and after PCV13 introduction.
  • * To identify emerging non-vaccine serotypes (NVTs) and assess antimicrobial resistance patterns.

Main Methods:

  • * A population-based prospective surveillance study of IPD in children (<14 years) in Andalusia (2018-2020).
  • * Comparison with historical data from 2006-2009 (pre-PCV13 introduction) using isolates from two major tertiary hospitals.
  • * Analysis of serotype and genotype distribution, and antimicrobial resistance profiles.

Main Results:

  • * A significant decline in IPD cases caused by PCV13 serotypes was observed post-PCV13 introduction (28% in 2018-2020 vs. pre-PCV13).
  • * The overall IPD incidence rate showed fluctuations, with a significant decline in 2020 compared to 2019.
  • * Serotypes 24F and 11A were the most prevalent NVTs, with some resistant clones belonging to CC156.

Conclusions:

  • * PCV13 vaccination has successfully reduced the burden of IPD caused by vaccine-type serotypes in children in Andalusia.
  • * Emerging NVTs, particularly serotypes 24F and 11A, are increasingly important and warrant ongoing surveillance due to their invasive potential and antibiotic resistance.
  • * Continued monitoring of IPD epidemiology and antimicrobial resistance is essential to adapt vaccination strategies and public health interventions.

Keywords:
GenotypesStreptococcus pneumoniaeinvasive pneumococcal diseasepneumococcal conjugate vaccineserotypes

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