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

Karen Elaine Lamb, Stefan Flasche, Matthew Diggle, Donald Inverarity, David Greenhalgh, Johanna Jefferies, Andrew Smith, Giles F S Edwards, Barbara Denham, Jim McMenamin, Eisin McDonald, Tim J Mitchell, Stuart C Clarke, Chris Robertson

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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
LanguageEnglish
Pages4356-4363
Number of pages8
JournalVaccine
Volume32
Issue number34
Early online date24 Jun 2013
DOIs
Publication statusPublished - 23 Jul 2014

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Scotland
serotypes
Serogroup
Immunization Schedule
vaccines
Serotyping
Conjugate Vaccines
Pneumococcal Vaccines
cerebrospinal fluid
Capsules
Cerebrospinal Fluid
immunization
Vaccination
Vaccines
Clone Cells
Logistic Models
vaccination
Pediatrics
clones
incidence

Keywords

  • invasive pneumococcal disease
  • sequence type
  • serotype
  • PCV7

Cite this

Lamb, Karen Elaine ; Flasche, Stefan ; Diggle, Matthew ; Inverarity, Donald ; Greenhalgh, David ; Jefferies, Johanna ; Smith, Andrew ; Edwards, Giles F S ; Denham, Barbara ; McMenamin, Jim ; McDonald, Eisin ; Mitchell, Tim J ; Clarke, Stuart C ; Robertson, Chris. / Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010. In: Vaccine. 2014 ; Vol. 32, No. 34. pp. 4356-4363.
@article{e62434f71b1d415399967ab038a3f466,
title = "Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010",
abstract = "Introduction The 7-valent pneumococcal conjugate vaccine (Prevenar{\circledR}, 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",
keywords = "invasive pneumococcal disease , sequence type, serotype, PCV7",
author = "Lamb, {Karen Elaine} and Stefan Flasche and Matthew Diggle and Donald Inverarity and David Greenhalgh and Johanna Jefferies and Andrew Smith and Edwards, {Giles F S} and Barbara Denham and Jim McMenamin and Eisin McDonald and Mitchell, {Tim J} and Clarke, {Stuart C} and Chris Robertson",
note = "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.",
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Lamb, KE, Flasche, S, Diggle, M, Inverarity, D, Greenhalgh, D, Jefferies, J, Smith, A, Edwards, GFS, Denham, B, McMenamin, J, McDonald, E, Mitchell, TJ, Clarke, SC & Robertson, C 2014, 'Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010' Vaccine, vol. 32, no. 34, pp. 4356-4363. https://doi.org/10.1016/j.vaccine.2013.05.079

Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010. / Lamb, Karen Elaine; Flasche, Stefan; Diggle, Matthew; Inverarity, Donald; Greenhalgh, David; Jefferies, Johanna; Smith, Andrew; Edwards, Giles F S; Denham, Barbara; McMenamin, Jim; McDonald, Eisin; Mitchell, Tim J; Clarke, Stuart C; Robertson, Chris.

In: Vaccine, Vol. 32, No. 34, 23.07.2014, p. 4356-4363.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Trends in serotypes and sequence types among cases of invasive pneumococcal disease in Scotland, 1999-2010

AU - Lamb, Karen Elaine

AU - Flasche, Stefan

AU - Diggle, Matthew

AU - Inverarity, Donald

AU - Greenhalgh, David

AU - Jefferies, Johanna

AU - Smith, Andrew

AU - Edwards, Giles F S

AU - Denham, Barbara

AU - McMenamin, Jim

AU - McDonald, Eisin

AU - Mitchell, Tim J

AU - Clarke, Stuart C

AU - Robertson, Chris

N1 - 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.

PY - 2014/7/23

Y1 - 2014/7/23

N2 - 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

AB - 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

KW - invasive pneumococcal disease

KW - sequence type

KW - serotype

KW - PCV7

U2 - 10.1016/j.vaccine.2013.05.079

DO - 10.1016/j.vaccine.2013.05.079

M3 - Article

VL - 32

SP - 4356

EP - 4363

JO - Vaccine

T2 - Vaccine

JF - Vaccine

SN - 0264-410X

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ER -