title: Clinical manifestations of invasive pneumococcal disease by vaccine and non-vaccine types.
abstract: 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.
authors.affiliation: Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden Both authors contributed equally.
authors.forename: Sarah
authors.initials: S
authors.lastname: Browall
authors.affiliation: Dept of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden Both authors contributed equally.
authors.forename: Erik
authors.initials: E
authors.lastname: Backhaus
authors.affiliation: Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden Dept of Infectious Diseases, Karolinska University Hospital, Solna, Sweden.
authors.forename: Pontus
authors.initials: P
authors.lastname: Naucler
authors.affiliation: Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ilias
authors.initials: I
authors.lastname: Galanis
authors.affiliation: Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Sjöström
authors.affiliation: Systems Biology Research Centre, School of Biosciences, University of Skövde, Skövde, Sweden.
authors.forename: Diana
authors.initials: D
authors.lastname: Karlsson
authors.affiliation: Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Berg
authors.affiliation: Dept of Paediatrics, Karolinska University Hospital, Solna, Sweden.
authors.forename: Joachim
authors.initials: J
authors.lastname: Luthander
authors.affiliation: Dept of Paediatrics, Karolinska University Hospital, Solna, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: Dept of Infectious Diseases, Karolinska University Hospital, Solna, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Spindler
authors.affiliation: Systems Biology Research Centre, School of Biosciences, University of Skövde, Skövde, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Ejdebäck
authors.affiliation: Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Birger
authors.initials: B
authors.lastname: Trollfors
authors.affiliation: Public Health Agency of Sweden, Solna, Sweden.
authors.forename: Jessica
authors.initials: J
authors.lastname: Darenberg
authors.affiliation: Dept of Infectious Diseases, Karolinska University Hospital, Solna, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Kalin
authors.affiliation: Dept of Communicable Diseases Control and Prevention, Stockholm County Council, Stockholm, Sweden Dept of Medicine, Unit of Infectious Diseases, Karolinska Institutet, Solna, Sweden.
authors.forename: Ake
authors.initials: A
authors.lastname: Örtqvist
authors.affiliation: Dept of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Rune
authors.initials: R
authors.lastname: Andersson
authors.affiliation: Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden Dept of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden birgitta.henriques@ki.se.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Henriques-Normark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D004269:DNA, Bacterial / Q000032:analysis*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D008875:Middle Aged; D017720:Molecular Epidemiology; D016017:Odds Ratio; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D065288:Serogroup; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D004269:DNA, Bacterial; D022242:Pneumococcal Vaccines