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. 2024 Nov 15;230(5):1243-1252.
doi: 10.1093/infdis/jiae184.

Pneumococci Isolated From Children in Community-Based Practice Differ From Isolates Identified by Population- and Laboratory-Based Invasive Disease Surveillance

Ravinder Kaur  1 , Ryan Gierke  2 , Lesley McGee  2 , Eduardo Gonzalez  1 , Miwako Kobayashi  2 , Michael Pichichero  1 ; Active Bacterial Core Surveillance (ABCs) Team
Collaborators, Affiliations

Pneumococci Isolated From Children in Community-Based Practice Differ From Isolates Identified by Population- and Laboratory-Based Invasive Disease Surveillance

Ravinder Kaur et al. J Infect Dis. .

Abstract

Background: Characterizing strains causing noninvasive and invasive pneumococcal disease (IPD) may inform the impact of new pneumococcal conjugate vaccines (PCVs).

Methods: During 2011-2019, among children aged 6-36 months, pneumococcal serotype distribution and antibiotic nonsusceptibility of nasopharyngeal and middle ear fluid (MEF) isolates collected at onset of acute otitis media (AOM) in Rochester, New York, were compared with IPD isolates from the Active Bacterial Core surveillance (ABCs) system across 10 US sites.

Results: From Rochester, 400 (nasopharyngeal) and 156 (MEF) pneumococcal isolates were collected from 259 children. From ABCs, 907 sterile-site isolates were collected from 896 children. Non-PCV serotypes 35B and 21 were more frequent among the Rochester AOM cases, while serotypes 3, 19A, 22F, 33F, 10A, and 12F contained in PCVs were more frequent among ABCs IPD cases. The proportion of antibiotic-nonsusceptible pneumococcal isolates was generally more common among IPD cases. In 2015-2019, serotype 35B emerged as the most common serotype associated with multiclass antibiotic nonsusceptibility for both the Rochester AOM and ABCs IPD cases.

Conclusions: Pneumococcal isolates from children in Rochester with AOM differ in serotype distribution and antibiotic susceptibility compared to IPD cases identified through US surveillance. Non-PCV serotype 35B emerged as a common cause of AOM and IPD.

Keywords: Streptococcus pneumoniae; PCV13; PCV15; PCV20; pneumococcal serotypes.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Pneumococcal serotypes of Rochester, New York vs Active Bacterial Core surveillance all sites of children aged 6–36 months, 2011–2019. There was no statistically significant difference between the Rochester nasopharyngeal (NP) and middle ear fluid (MEF) populations. The 400 NP isolates came from 253 children, while the 156 MEF isolates came from 126 children; 120 children are present in both groups. Eight hundred ninety-six children had 907 invasive pneumococcal disease (IPD) isolates; 11 children had 2 isolates from separate IPD episodes. *Statistically significant difference for NP vs IPD isolates only. $Statistically significant difference for both NP vs IPD and MEF vs IPD isolates. †Non-PCV20 serotypes that represent <1% in any group. Isolates that were not fully typed because they are uncommon (such as 25/38/43/44/45/46/48) or isolates not fully subtyped (such as 24A/24B/24F). Unknown isolates were not used in determining statistical significance. Abbreviations: ABCs, Active Bacterial Core surveillance; AOM, acute otitis media; IPD, invasive pneumococcal disease; MEF, middle ear fluid; NP, nasopharyngeal; PCV, pneumococcal conjugate vaccine.
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