A global epidemic serotype 14 Streptococcus pneumoniae switching to non-vaccine types

Jinglin Yue1,2, Lei Chen3, Tingzhu Yao1,2

  • 1Biomedical Innovation Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Microbiology Spectrum
|March 31, 2025
PubMed

Insights

Pneumococcal conjugate vaccines (PCV) reduce vaccine-type bacteria, but non-vaccine types (NVT) increase. A serotype switch from 14 to 15B in a prevalent strain shows adaptive evolution, potentially leading to future pandemics.

Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Streptococcus pneumoniae causes pneumonia globally, with vaccine-type strains decreasing post-PCV introduction.
  • Non-vaccine-type (NVT) S. pneumoniae strains have increased, particularly in nasopharyngeal carriage and disease incidence.
  • Serotype switching, involving alterations in the cps gene locus, is a key concern for vaccine effectiveness.

Purpose of the Study:

  • To analyze S. pneumoniae clinical isolates for serotype distribution and evaluate vaccine effectiveness.
  • To identify multidrug-resistant NVT S. pneumoniae, focusing on the CC876 complex and serotype 14 clones.
  • To investigate a potential serotype switch event from serotype 14 to 15B in a prevalent ST4749 strain.

Main Methods:

  • High-throughput sequencing of 166 S. pneumoniae clinical isolates from Xiamen Children's Hospital, China.
  • Serotyping of isolates to assess vaccine type prevalence and identify NVT strains.
  • Genomic analysis to map recombination sites and identify genetic elements involved in serotype switching.

Main Results:

  • A significant increase in NVT S. pneumoniae prevalence was observed, correlating with PCV introduction.
  • Identification of multidrug-resistant NVT S. pneumoniae within the epidemic CC876 complex.
  • Discovery of a serotype 15B/ST4749 strain, likely resulting from a serotype switch from serotype 14/ST4749, involving the cps locus and comC.

Conclusions:

  • The study highlights the adaptive evolution of S. pneumoniae under vaccination pressure, evidenced by serotype switching.
  • The identified novel NVT strain (15B/ST4749) demonstrates potential for future pandemic emergence.
  • Findings offer insights for optimizing S. pneumoniae prevention, control strategies, and vaccine deployment.

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