AI Article Synopsis

  • The introduction of pneumococcal conjugate vaccines (PCV) significantly decreased pneumococcal infections in Poland, but led to an increase in non-vaccine serotype 19A strains, which became a major cause of invasive pneumococcal disease globally.
  • A study characterized 19A invasive pneumococci strains in Poland prior to PCV implementation in 2017, analyzing their genetic and resistance profiles compared to isolates from other countries where PCVs were introduced earlier.
  • Results showed that 19A accounted for 4.7% of invasive strains collected from 1997 to 2016, with GPSC1/CC320 being highly resistant and distinct from other global strains, indicating a concerning rise

Article Abstract

Introduction: The introduction of pneumococcal conjugate vaccines (PCV) into the national immunization programs (NIPs) has significantly reduced the number of pneumococcal infections. However, infections caused by isolates of non-vaccine serotypes (NVT) started spreading shortly thereafter and strains of NVT 19A have become the main cause of invasive pneumococcal disease burden worldwide. The aim of the study was to characterize serotype 19A invasive pneumococci of GPSC1/CC320 circulating in Poland before the introduction of PCV into the Polish NIP in 2017 and to compare them to isolates from other countries where PCVs were implemented much earlier than in Poland.

Methods: All the GPSC1/CC320 isolates were analyzed by serotyping, susceptibility testing, and whole genome sequencing followed by analyses of resistome, virulome, and core genome multilocus sequence typing (cgMLST), including comparative analysis with isolates with publicly accessible genomic sequences (PubMLST).

Results: During continuous surveillance the NRCBM collected 4237 invasive Streptococcus pneumoniae isolates between 1997 and 2016, including 200 isolates (4.7%) of serotype 19A. The most prevalent among 19A pneumococci were highly resistant representatives of Global Pneumococcal Sequence Cluster 1/Clonal Complex 320, GPSC1/CC320 (n = 97, 48.5%). Isolates of GPSC1/CC320 belonged to three sequence types (STs): ST320 (75.2%) ST4768 (23.7%), and ST15047 (1.0%), which all represented the 19A-III cps subtype and had complete loci for both PI-1 and PI-2 pili types. On the basis of the cgMLST analysis the majority of Polish GPSC1/CC320 isolates formed a group clearly distinct from pneumococci of this clone observed in other countries.

Conclusion: Before introduction of PCV in the Polish NIP we noticed an unexpected increase of serotype 19A in invasive pneumococcal infections, with the most common being representatives of highly drug-resistant GPSC1/CC320 clone, rarely identified in Europe both before and even after PCV introduction.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505132PMC
http://dx.doi.org/10.1007/s40121-023-00842-wDOI Listing

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