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. 2014 Sep 18;9(9):e107666.
doi: 10.1371/journal.pone.0107666. eCollection 2014.

Population snapshot of Streptococcus pneumoniae causing invasive disease in South Africa prior to introduction of pneumococcal conjugate vaccines

Kedibone M Ndlangisa  1 , Mignon du Plessis  1 , Nicole Wolter  1 , Linda de Gouveia  2 , Keith P Klugman  3 , Anne von Gottberg  1 ; GERMS-SA  4
Affiliations

Population snapshot of Streptococcus pneumoniae causing invasive disease in South Africa prior to introduction of pneumococcal conjugate vaccines

Kedibone M Ndlangisa et al. PLoS One. .

Abstract

We determined the sequence types of isolates that caused invasive pneumococcal disease (IPD) prior to routine use of pneumococcal conjugate vaccines (PCV) in South Africa. PCV-13 serotypes and 6C isolates collected in 2007 (1 461/2 437, 60%) from patients of all ages as part of on-going, national, laboratory-based surveillance for IPD, were selected for genetic characterization. In addition, all 134 non-PCV isolates from children <2 years were selected for characterization. Sequence type diversity by serotype and age category (children <5 years vs. individuals ≥5 years) was assessed for PCV serotypes using Simpson's index of diversity. Similar genotypes circulated among isolates from children and adults and the majority of serotypes were heterogeneous. While globally disseminated clones were common among some serotypes (e.g., serotype 1 [clonal complex (CC) 217, 98% of all serotype 1] and 14 [CC230, 43%)]), some were represented mainly by clonal complexes rarely reported elsewhere (e.g., serotype 3 [CC458, 60%] and 19A [CC2062, 83%]). In children <2 years, serotype 15B and 8 were the most common serotypes among non-PCV isolates (16% [22/134] and 15% [20/134] isolates, respectively). Sequence type 7052 and 53 were most common among serotypes 15B and 8 isolates and accounted for 58% (7/12) and 64% (9/14) of the isolates, respectively. Serotype 19F, 14, 19A and 15B had the highest proportions of penicillin non-susceptible isolates. Genotypes rarely reported in other parts of the world but common among some of our serotypes highlight the importance of our data as these genotypes may emerge post PCV introduction.

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Conflict of interest statement

Competing Interests: Anne von Gottberg and Mignon du Plessis have received research funding from Pfizer. In addition, Anne von Gottberg has received research funding from Sanofi Pasteur. Keith P. Klugman has received consultancy fees from Pfizer, Sanofi Pasteur, and Novartis. This work was funded by the National Health Laboratory Service, Centers for Disease Control and Prevention (CDC), National Centre for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Global AIDS Program Cooperative Agreement U62/PSO022901. (The contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC). Molecular characterization of isolates was funded by Pfizer Vaccines Research. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Distribution of pneumococcal serotypes causing invasive disease in South Africa, by age group, 2007 (n = 3 194).
‘Other’ indicates serotypes not included in pneumococcal conjugate vaccines (PCV-13 and 6C).
Figure 2
Figure 2. Diversity of sequence types within serotypes.
Simpson’s index of diversity was used to assess diversity of isolates that caused invasive pneumococcal disease in 2007 among individuals of all ages, South Africa.
See this image and copyright information in PMC

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