Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010

Lamb, Karen Elaine and Flasche, Stefan and Diggle, Matthew and Inverarity, Donald and Greenhalgh, David and Jefferies, Johanna and Smith, Andrew and Edwards, Giles F S and Denham, Barbara and McMenamin, Jim and McDonald, Eisin and Mitchell, Tim J and Clarke, Stuart C and Robertson, Chris (2014) Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010. Vaccine, 32 (34). pp. 4356-4363. ISSN 1873-2518 (https://doi.org/10.1016/j.vaccine.2013.05.079)

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Abstract

Introduction The 7-valent pneumococcal conjugate vaccine (Prevenar®, Wyeth; PCV7) was introduced to the UK paediatric immunisation schedule in 2006. This study investigates trends in serotypes and multi locus sequence types (STs) among cases of invasive pneumococcal disease (IPD) in Scotland prior to, and following, the introduction of PCV7. Methods Scottish Invasive Pneumococcal Disease Enhanced Surveillance has records of all cases of invasive pneumococcal disease in Scotland since 1999. Cases diagnosed from blood or cerebrospinal fluid isolates until 2010 were analysed. Logistic and poisson regression modelling was used to assess trends prior to and following the introduction of PCV7. Results Prior to PCV7 use, on average 650 cases of IPD were reported each year; 12% occurred in those aged <5 years and 35% affected those aged over 65 years. Serotypes in PCV7 represented 47% of cases (68% in <5 year olds). The serotype and ST distribution was relatively stable with only serotype 1 and associated ST 306 showing an increasing trend. PCV7 introduction was associated with a 69% (95% CI: 50%, 80%) reduction in the incidence of IPD among those aged <5 years, a 57% (95% CI: 47%, 66%) reduction among those aged 5-64 years but no significant change among those aged 65 years and over where increases in non-PCV7 serotypes were observed. Serotypes which became more prevalent post-PCV7 are those which were associated with STs related to the PCV7 serotypes. Conclusions Routine serotyping and sequence typing in Scotland allowed the assessment of the relationship between the capsule and the clones in the post vaccination era. Changes in the distribution of serotypes post PCV7 introduction appear to be driven by associations between serotypes and STs prior to PCV7 introduction. This has implications for the possible effects of the introduction of higher valency vaccines and could aid in predicting replacement serotypes in IPD

ORCID iDs

Greenhalgh, David ORCID: https://orcid.org/0000-0001-5380-3307

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  Item type:	Article
  ID code:	49797
  Dates:	Date Event 23 July 2014 Published 24 June 2013 Published Online 20 May 2013 Accepted
  Notes:	NOTICE: this is the author’s version of a work that was accepted for publication in Vaccine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Vaccine [VOL32, ISSUE 34, (23/7/14] DOI: 10.1016/j.vaccine.2013.05.079.
  Subjects:	Science > Mathematics > Probabilities. Mathematical statistics Science > Microbiology > Virology
  Department:	Faculty of Science > Mathematics and Statistics
  Depositing user:	Pure Administrator
  Date deposited:	14 Oct 2014 14:17
  Last modified:	11 Nov 2024 10:48
  URI:	https://strathprints.strath.ac.uk/id/eprint/49797