PT  - JOURNAL ARTICLE
AU  - Sarah Browall
AU  - Erik Backhaus
AU  - Pontus Naucler
AU  - Ilias Galanis
AU  - Karin Sjöström
AU  - Diana Karlsson
AU  - Stefan Berg
AU  - Joachim Luthander
AU  - Margareta Eriksson
AU  - Carl Spindler
AU  - Mikael Ejdebäck
AU  - Birger Trollfors
AU  - Jessica Darenberg
AU  - Mats Kalin
AU  - Åke Örtqvist
AU  - Rune Andersson
AU  - Birgitta Henriques-Normark
TI  - Clinical manifestations of invasive pneumococcal disease by vaccine and non-vaccine types
AID  - 10.1183/09031936.00080814
DP  - 2014 Jan 01
TA  - European Respiratory Journal
PG  - erj00808-2014
4099  - http://erj.ersjournals.com/content/early/2014/10/16/09031936.00080814.short
4100  - http://erj.ersjournals.com/content/early/2014/10/16/09031936.00080814.full
AB  - 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. Pneumococcal non-vaccine type strains cause severe disease, but with different spectrums of clinical manifestations http://ow.ly/ABYnz