Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

By Stephanie W Lo, Rebecca A Gladstone, Andries J van Tonder, John A Lees, Mignon du Plessis, Rachel Benisty, Noga Givon-Lavi, Paulina A Hawkins, Jennifer E Cornick, Brenda Kwambana-Adams, Pierra Y Law, Pak Leung Ho, Martin Antonio, Dean B Everett, Prof Ron Dagan, Anne von Gottberg, Prof Keith P Klugman, Lesley McGee, Robert F Breiman, Stephen D Bentley, and The Global Pneumococcal Sequencing Consortium

The Lancet Infectious Diseases, June 10, 2019

 

Invasive pneumococcal disease remains an important health priority owing to increasing disease incidence caused by pneumococci expressing non-vaccine serotypes. We previously defined 621 Global Pneumococcal Sequence Clusters (GPSCs) by analysing 20 027 pneumococcal isolates collected worldwide and from previously published genomic data. In this study, we aimed to investigate the pneumococcal lineages behind the predominant serotypes, the mechanism of serotype replacement in disease, as well as the major pneumococcal lineages contributing to invasive pneumococcal disease in the post-vaccine era and their antibiotic resistant traits.

We whole-genome sequenced 3233 invasive pneumococcal disease isolates from laboratory-based surveillance programmes in Hong Kong (n=78), Israel (n=701), Malawi (n=226), South Africa (n=1351), The Gambia (n=203), and the USA (n=674). The genomes represented pneumococci from before and after pneumococcal conjugate vaccine (PCV) introductions and were from children younger than 3 years. We identified predominant serotypes by prevalence and their major contributing lineages in each country, and assessed any serotype replacement by comparing the incidence rate between the pre-PCV and PCV periods for Israel, South Africa, and the USA. We defined the status of a lineage as vaccine-type GPSC (≥50% 13-valent PCV [PCV13] serotypes) or non-vaccine-type GPSC (>50% non-PCV13 serotypes) on the basis of its initial serotype composition detected in the earliest vaccine period to measure their individual contribution toward serotype replacement in each country. Major pneumococcal lineages in the PCV period were identified by pooled incidence rate using a random effects model.

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Haemophilus influenzae type b vaccination and anthropometric, cognitive, and schooling outcomes among Indian children

By Arindam Nandi, Anil B. Deolalikar, David E. Bloom, Ramanan Laxminarayan

Annals of the New York Academy of Sciences, June 10, 2019

 

Haemophilus influenzae type b (Hib) affects 337,000 Indian children every year. A vaccine against Hib was introduced in 2011 as part of the pentavalent vaccine and scaled up nationwide. This study investigated the associations between Hib vaccination and child anthropometry, cognition, and schooling outcomes in India. We used longitudinal survey data and employed propensity score matching to control for observed systematic differences between children who reported receipt or nonreceipt of Hib vaccine before age 6 years (n = 1824). Z‐scores of height‐for‐age (HAZ) and BMI‐for‐age (BMIZ), percentage scores of English, mathematics, reading, and Peabody Picture Vocabulary tests, and attained schooling grade of children were examined. Hib‐vaccinated children had 0.25 higher HAZ, scored 4.09 percentage points (pp) higher on the English test and 4.78 pp higher on the mathematics test, and attained 0.16 more schooling grades than Hib‐unvaccinated children at age 11–12 years. At age 14–15 years, they had 0.18 higher HAZ, scored 3.63 pp higher on the reading test and 3.22 pp higher on the mathematics test, and attained 0.15 more schooling grades than Hib‐unvaccinated children. The findings indicate potential long‐term health, cognitive, and schooling benefits of the Hib vaccine, subject to the effect of unobserved confounding factors.

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Predictors of uptake of newly introduced vaccines in Malawi – monovalent human rotavirus and pneumococcal conjugate vaccines: Evidence from the 2015–16 Malawi demographic and health survey

By Peter Austin Morton Ntenda, Edward Tisungane Mwenyenkulu, Nuntiput Putthanachote, Owen Nkoka, Thomas Gabriel Mhone, Mfundi President Sebenele Motsa, Tinashe Tizifa

Journal of Tropical Pediatrics, June 2019

 

The purpose of this study was to examine the uptake and predictors of monovalent human rotavirus and pneumococcal conjugate vaccines among children of age 12–35 months in Malawi.

This study used cross-sectional data obtained from the 2015–16 Malawi Demographic and Health Survey. Multivariate logistic regression was used to identify the factors related to uptake of pneumococcal and rotavirus vaccination.

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Neutralizing Antibody Responses to Homologous and Heterologous H1 and H3 Influenza A Strains After Vaccination With Inactivated Trivalent Influenza Vaccine Vary With Age and Prior-year Vaccination

By Wei Wang, Qiong Chen, Lauren A Ford-Siltz, Leah C Katzelnick, Gabriel I Parra, Hyo Sook Song, Russell Vassell, Carol D Weiss

Clinical Infectious Diseases, to be published June 15, 2019

 

Prior influenza immunity influences the homologous neutralizing antibody responses elicited by inactivated influenza vaccines (IIV), but neutralizing antibody responses to heterologous strains have not been extensively characterized.

We analyzed neutralizing antibody titers in individuals aged 1–88 who received the 2009–2010 season IIV before infection by or vaccination against the 2009 pandemic H1N1 virus. Neutralization titers to homologous and heterologous past, recent, and advanced H1 and H3 strains, as well as H2, H5, and H7 strains, were measured using influenza hemagglutinin pseudoviruses. We performed exploratory analyses based on age, prior-year IIV, and prevaccination titer, without controlling for Type I errors.

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Impact of the 13-Valent Pneumococcal Conjugate Vaccine on the Incidence of All-cause Pneumonia in Adults Aged ≥60 Years: A Population-based, Retrospective Cohort Study

By Martin Kolditz, Jochen Schmitt, Mathias W Pletz, Falko Tesch

Clinical Infectious Diseases, to be published June 15, 2019

 

In this population-based study evaluating the effectiveness of the 13-valent pneumococcal conjugate vaccine (2012–2016) to prevent all-cause pneumonia in adults ≥60 years of age, we found significant, 0.63% absolute risk and 11.9% relative risk reductions on the 3-year (2014–2016) cumulative incidences of all-cause pneumonia after vaccination.

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