RT Journal Article
SR Electronic
T1 Clinical manifestations of invasive pneumococcal disease by vaccine and non-vaccine types
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00808-2014
DO 10.1183/09031936.00080814
A1 Sarah Browall
A1 Erik Backhaus
A1 Pontus Naucler
A1 Ilias Galanis
A1 Karin Sjöström
A1 Diana Karlsson
A1 Stefan Berg
A1 Joachim Luthander
A1 Margareta Eriksson
A1 Carl Spindler
A1 Mikael Ejdebäck
A1 Birger Trollfors
A1 Jessica Darenberg
A1 Mats Kalin
A1 Åke Örtqvist
A1 Rune Andersson
A1 Birgitta Henriques-Normark
YR 2014
UL http://erj.ersjournals.com/content/early/2014/10/16/09031936.00080814.abstract
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