Clinical manifestations of invasive pneumococcal disease by vaccine and non-vaccine types

May 23, 2015 at 6:02 pm

Eur Respir J 2014 44:6, 1646-1657

Sarah Browall, Erik Backhaus, Pontus Naucler, Ilias Galanis, Karin Sjöström, Diana Karlsson, Stefan Berg, Joachim Luthander, Margareta Eriksson, Carl Spindler, Mikael Ejdebäck, Birger Trollfors, Jessica Darenberg, Mats Kalin, Åke Örtqvist, Rune Andersson, and Birgitta Henriques-Normark

1Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden

2Dept of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden

3Dept of Infectious Diseases, Karolinska University Hospital, Solna, Sweden

4Systems Biology Research Centre, School of Biosciences, University of Skövde, Skövde, Sweden

5Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden

6Dept of Paediatrics, Karolinska University Hospital, Solna, Sweden

7Public Health Agency of Sweden, Solna, Sweden

8Dept of Communicable Diseases Control and Prevention, Stockholm County Council, Stockholm, Sweden

9Dept of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Solna, Sweden

10Dept of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

11Dept of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden

12Both authors contributed equally

Birgitta Henriques-Normark, Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobelsväg 16, 171 77 Stockholm, Sweden. E-mail: birgitta.henriques{at} 


Pneumococcal conjugated vaccines (PCVs) have shown protection against invasive pneumococcal disease by vaccine serotypes, but an increase in non-vaccine serotype disease has been observed. Type-specific effects on clinical manifestation need to be explored.

Clinical data from 2096 adults and 192 children with invasive pneumococcal disease were correlated to pneumococcal molecular serotypes. Invasive disease potential for pneumococcal serotypes were calculated using 165 invasive and 550 carriage isolates from children.

The invasive disease potential was lower for non-PCV13 compared to vaccine-type strains. Patients infected with non-PCV13 strains had more underlying diseases, were less likely to have pneumonia and, in adults, tended to have a higher mortality. Furthermore, patients infected with pneumococci belonging to clonal serotypes only expressing non-PCV13 capsules had a higher risk for septicaemia and mortality.

PCV vaccination will probably lead to a decrease in invasive pneumococcal disease but an alteration in the clinical manifestation of invasive pneumococcal disease. Genetic lineages causing invasive pneumococcal disease in adults often express non-vaccine serotypes, which can expand after vaccination with an increased risk of infection in patients with underlying diseases.



Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Infecciones respiratorias, Inmunizaciones, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update.

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