title: Evolving pneumococcal serotypes and sequence types in relation to high antibiotic stress and conditional pneumococcal immunization.
abstract: In Taiwan, beginning in 2013, the 13-valent pneumococcal conjugate vaccine (PCV13) was provided free of charge to children 2-5 years of age. In 2014, this was extended to children 1-5 years old. During 2012-2014, 953 cases of culture-confirmed pneumococcal disease (CCPD), including 104 invasive pneumococcal disease (IPD), were prospectively identified and analyzed at a 3,700-bed hospital in Taiwan. From 2012 to 2014, the incidence per 10,000 admissions decreased from 26.7 to 20.4 for CCPD (P < 0.001) and from 3.2 to 1.9 for IPD (P < 0.05). Significant reduction of PCV13 serotypes was firstly noted in children in 2013 and extended to both paediatric and adult populations in 2014. Simultaneously, the incidence per 10,000 admissions of non-PCV13 serotypes increased from 6.1 in 2012 to 9.3 in 2014 (P < 0.005). The most prevalent non-PCV13 serotypes were 15A, 15B, and 23A, each containing a predominant clone, ST63(15A), ST83(15B), and ST338(23A). From 2012 to 2014, isolates with penicillin minimum inhibitory concentrations >2 mg/L decreased from 27.8% to 8.1% (P < 0.001) among all isolates. PCV13 immunization in young children demonstrated an early protective effect in all ages. However, in the elderly, the effect was compromised by an emergence of non-PCV13 serotypes.
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.|Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
authors.forename: Lin-Hui
authors.initials: LH
authors.lastname: Su
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.
authors.forename: An-Jing
authors.initials: AJ
authors.lastname: Kuo
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.
authors.forename: Ju-Hsin
authors.initials: JH
authors.lastname: Chia
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
authors.forename: Hsin-Chieh
authors.initials: HC
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.
authors.forename: Tsu-Lan
authors.initials: TL
authors.lastname: Wu
authors.affiliation: Institute for Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, 333, Taiwan.|Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007114:Immunization / Q000379:methods; D015994:Incidence; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology*; D022242:Pneumococcal Vaccines / Q000276:immunology; D015995:Prevalence; D065288:Serogroup; D012703:Serotyping / Q000379:methods; D013296:Streptococcus pneumoniae / Q000276:immunology*; D013624:Taiwan / Q000453:epidemiology; D014611:Vaccination / Q000379:methods; D018074:Vaccines, Conjugate / Q000276:immunology*; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate