title: Serotypes and genotypes of invasive Streptococcus pneumoniae before and after PCV10 implementation in southern Brazil.
abstract: To reduce the burden of pneumococcal diseases, different formulations of pneumococcal conjugate vaccines (PCV) have been introduced in many countries. In Brazil, PCV10 has been available since 2010. We aimed to analyze the serotype and genetic composition of invasive pneumococci from Brazil in pre- and post-vaccination periods (2007-2012). Antibiotic susceptibility was determined and genotypes of macrolide and fluoroquinolone resistance were characterized. The genotypes of isolates of the most frequent serotypes were determined by multilocus sequence typing. The study included 325 isolates, which were primarily recovered from blood. The most common serotypes recovered were 14, 3, 4, 23F, 7F, 9V, 12F, 20, 19F, 8, 19A, and 5. Thirty-eight pneumococci (11.7%) were from children ≤5 years old. Considering the overall population, PCV10 and PCV13 serotype coverage was 50.1% and 64.9%, respectively. During the pre-vaccine period, isolates with serotypes belonging to the PVC10 represented 51.5% (100/194), whereas in the post vaccine they represented 48.0% (63/131). PCV13 serotypes represented 67.5% (131/194) and 59.2% (77/131) of total for pre- and post-vaccination periods, respectively. Seventy different sequence types [STs] were found, accounting for 9 clonal complexes [CCs] and 45 singletons. Eight STs (156, 180, 218, 8889, 53, 191, 770, and 4967) represented the majority (51.5%) of isolates. Fifty STs were associated with the pre-vaccination period (27 exclusive) and 43 (20 exclusive) with the post-vaccination period; 23 STs were identified in both periods. Some serotypes were particularly clonal (7F, 8, 12F, 20). Non-susceptibility to penicillin was associated with serotype 19A, CC320. Erythromycin resistance was heterogeneous when considering serotype and ST. A single serotype 23F (ST4967) isolate was resistant to levofloxacin. Continued surveillance is required to determine vaccine impact and to monitor changes in pneumococcal population biology post-PCV10 introduction in Brazil.
authors.affiliation: Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Caierão
authors.affiliation: Emory University, Atlanta, Georgia, United States of America.
authors.forename: Paulina
authors.initials: P
authors.lastname: Hawkins
authors.affiliation: Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Fernando Hayashi
authors.initials: FH
authors.lastname: Sant'anna
authors.affiliation: Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Gabriela Rosa
authors.initials: GR
authors.lastname: da Cunha
authors.affiliation: Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Pedro Alves
authors.initials: PA
authors.lastname: d'Azevedo
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Lesley
authors.initials: L
authors.lastname: McGee
authors.affiliation: Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Cícero
authors.initials: C
authors.lastname: Dias
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001938:Brazil; D024881:Drug Resistance, Bacterial / Q000235:genetics / Q000276:immunology; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D012189:Retrospective Studies; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification
chemical_list: C586648:10-valent pneumococcal conjugate vaccine; D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines; D004917:Erythromycin