title: Population structure of invasive Streptococcus pneumoniae isolates among Alaskan children in the conjugate vaccine era, 2001 to 2013.
abstract: Here we describe the relationships between serotypes, genotypes, and antimicrobial susceptibility among isolates causing invasive pneumococcal disease in Alaskan children during the pneumococcal conjugate vaccine (PCV) era. From 2001 to 2013 we received 271 isolates representing 33 serotypes. The most common serotypes were 19A (29.5%, n= 80), 7F (12.5%, n= 34), 15B/C (6.3%, n= 17), and 22F (4.8%, n= 13). Multilocus sequence typing identified 11 clonal complexes (CC) and 45 singletons. Five CCs accounted for 52% (141/271) of the total: CC199 (21% [n= 57], serotypes 19A, 15B/C), CC191 (12.2% [n= 33], serotype 7F), CC172 (10.3% [n= 28], serotypes 19A, 23A, 23B), CC433 (4.4% [n= 12], serotype 22F), and CC100 (4.4% [n= 12], serotype 33F). The proportion of isolates nonsusceptible to erythromycin and tetracycline increased after 13-valent PCV use (14% [n= 30] versus 29% [n= 14]; P= 0.010) and (4% [n= 9] versus 22% [n= 11]; P< 0.001), respectively. The genetic diversity also increased after 13-valent PCV use (Simpson's diversity index =0.95 versus 0.91; P= 0.022).
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA. Electronic address: kmiernyk@cdc.gov.
authors: Karen M
authors: KM
authors: Miernyk
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Lisa R
authors: LR
authors: Bulkow
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Samantha L
authors: SL
authors: Case
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Tammy
authors: T
authors: Zulz
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Michael G
authors: MG
authors: Bruce
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Marcella
authors: M
authors: Harker-Jones
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Debby A
authors: DA
authors: Hurlburt
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Thomas W
authors: TW
authors: Hennessy
authors: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infections Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre, Dr., Anchorage, AK, 99508, USA.
authors: Karen M
authors: KM
authors: Rudolph
mesh_terms: D000413:Alaska / Q000453:epidemiology; D002675:Child, Preschool; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D058885:Multilocus Sequence Typing; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D065288:Serogroup; D022541:Streptococcal Vaccines / Q000008:administration & dosage / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D022541:Streptococcal Vaccines
keywords: Antimicrobial susceptibility; Molecular epidemiology; Multilocus sequence typing; Pneumococcal conjugate vaccines; Serotypes; Streptococcus pneumoniae