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Streptococcus pneumoniae carriage, serotypes, genotypes, and antimicrobial resistance trends among children in Portugal, after introduction of PCV13 in National Immunization Program

2024-09-17Artigo científico Acesso aberto
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dc.contributor.authorCandeias, Catarina
dc.contributor.authorAlmeida, Sónia T.
dc.contributor.authorPaulo, A. Cristina
dc.contributor.authorSimões, Alexandra S.
dc.contributor.authorFerreira, Bárbara
dc.contributor.authorCruz, Ana R.
dc.contributor.authorQueirós, Miguel
dc.contributor.authorTouret, Tiago
dc.contributor.authorBrito-Avô, António
dc.contributor.authorde Lencastre, Hermínia
dc.contributor.authorSá-Leão, Raquel
dc.contributor.institutionInstituto de Tecnologia Química e Biológica António Xavier (ITQB)
dc.contributor.institutionMolecular, Structural and Cellular Microbiology (MOSTMICRO)
dc.contributor.pblElsevier
dc.date.accessioned2025-05-07T21:19:27Z
dc.date.available2025-05-07T21:19:27Z
dc.date.issued2024-09-17
dc.descriptionFunding Information: This work was supported by unrestricted research grant from Pfizer (to RSL), and through MOSTMICRO (LISBOA-01-0145-FEDER-007660) funded by FEDER through COMPETE2020 \u2013 Programa Operacional Competitividade e Internacionaliza\u00E7\u00E3o (POCI) . CC and BF were supported by grants PD/BD/148434/2019 and 2020.05293.BD, respectively. Publisher Copyright: © 2024 The Authors
dc.description.abstractStreptococcus pneumoniae carriage studies are crucial to monitor changes induced by use of pneumococcal conjugate vaccines and inform vaccination policies. In this cross-sectional study, we examined changes within the pneumococcal population following introduction of PCV13 in 2015 in the National Immunization Program (NIP), in Portugal. In 2018–2020 (NIP-PCV13), we obtained 1450 nasopharyngeal samples from children ≤6 years attending day-care. We assessed serotypes, antimicrobial resistance, and genotypes (MLST and GPSC) and compared findings with earlier periods: 2009–2010 (pre-PCV13), 2011–2012 (early-PCV13), and 2015–2016 (late-PCV13). Pneumococcal carriage prevalence remained stable at 60.2 %. Carriage of PCV13 serotypes was 10.7 %, markedly reduced compared to pre-PCV13 period (47.6 %). The most prevalent PCV13 serotypes were 19F, 3, and 19A all showing a significant decreasing trend compared to the pre-PCV13 period (from 7.1 % to 4.7 %, 10.1 % to 1.8 %, and 14.1 % to 1.8 %, respectively), a notable observation given the described limited effectiveness of PCV13 against serotype 3. Non-vaccinated children and children aged 4–6 years were more likely to carry PCV13 serotypes (2.5-fold, 95 %CI [1.1–5.6], and 2.9-fold, 95 %CI [1.3–6.8], respectively). The most prevalent non-PCV13 serotypes were 15B/C, 11A, 23B, 23A, and NT, collectively accounting for 51.9 % of all isolates. In total, 30.5 % of all pneumococci were potentially covered by PCV20. Resistance to penicillin (low-level) and macrolides increased significantly, from 9.3 % and 13.4 %, respectively, in the late-PCV13 period, to approximately 20 % each, mostly due to lineages expressing non-PCV13 serotypes, nearing pre-PCV13 levels. An expansion of lineages traditionally associated with PCV13 serotypes, like CC156-GPSC6 (serotype 14) and CC193-GPSC11 (serotype 19F), but now predominantly expressing non-PCV13 serotypes (11A, 15B/C, and 24F for GPSC6; and 15A and 21 for GPSC11) was noted. These findings indicate that the pneumococcal population is adapting to the pressures conferred by PCV13 and antimicrobial use and indicate the need to maintain close surveillance.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent2511011
dc.identifier.doi10.1016/j.vaccine.2024.126219
dc.identifier.issn0264-410X
dc.identifier.otherPURE: 99909567
dc.identifier.otherPURE UUID: faad780a-5527-4d04-b0b1-1b4826cd5543
dc.identifier.otherScopus: 85201282417
dc.identifier.otherPubMed: 39146858
dc.identifier.otherORCID: /0000-0002-9249-2609/work/183499837
dc.identifier.urihttp://hdl.handle.net/10362/182747
dc.identifier.urlhttps://www.scopus.com/pages/publications/85201282417
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAntimicrobial resistance
dc.subjectCarriage
dc.subjectGPSC
dc.subjectPneumococcal conjugate vaccine
dc.subjectSerotype
dc.subjectStreptococcus pneumoniae
dc.subjectMolecular Medicine
dc.subjectGeneral Immunology and Microbiology
dc.subjectGeneral Veterinary
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleStreptococcus pneumoniae carriage, serotypes, genotypes, and antimicrobial resistance trends among children in Portugal, after introduction of PCV13 in National Immunization Programen
dc.title.subtitleA cross-sectional studyen
dc.typejournal article
degois.publication.issue22
degois.publication.titleVaccine
degois.publication.volume42
dspace.entity.typePublication
rcaap.rightsopenAccess

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