Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;29(45):2400108.
doi: 10.2807/1560-7917.ES.2024.29.45.2400108.

Non-invasive Streptococcus pneumoniae infections are associated with different serotypes than invasive infections, Belgium, 2020 to 2023

Ioannis Passaris  1 , Stéphanie Depickère  2 , Toon Braeye  3 , Marina Mukovnikova  4 , Alexandra Vodolazkaia  4 , Chloé Abels  5 , Lize Cuypers  6   7 , Stefanie Desmet  6   7 , Pieter-Jan Ceyssens  1 ; NIPD study group Belgium  8
Collaborators, Affiliations

Non-invasive Streptococcus pneumoniae infections are associated with different serotypes than invasive infections, Belgium, 2020 to 2023

Ioannis Passaris et al. Euro Surveill. 2024 Nov.

Abstract

BackgroundDespite widely implemented pneumococcal vaccination programmes, Streptococcus pneumoniae remains a global risk for human health. Streptococcus pneumoniae can cause invasive (IPD) or non-invasive pneumococcal disease (NIPD). Surveillance is mainly focusing on IPD, assessing the full impact of pneumococcal vaccination programmes on pneumococcal disease is challenging.AimWe aimed to prospectively investigate serotype distribution and antimicrobial resistance (AMR) of S. pneumoniae isolates from patients with NIPD and compare with data on IPD isolates and with a 2007-2008 dataset on NIPD.MethodsBetween September 2020 and April 2023, we collected isolates and patient data from patients with NIPD from 23 clinical laboratories in Belgium. Capsular typing was performed by a validated Fourier-Transform Infrared spectroscopic method, and AMR was assessed with broth microdilution, using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints.ResultsWe received S. pneumoniae isolates from 1,008 patients with lower respiratory tract infections (n = 760), otitis media (n = 190) and sinusitis (n = 58). Serotype 3 was the most prevalent serotype among the NIPD isolates. Serotypes not included in the 20-valent pneumococcal conjugate vaccine (PCV20) were significantly more common among the NIPD than among the IPD isolates. Antimicrobial resistance levels were significantly higher among the NIPD isolates (n = 539; 2020-2022) compared with the IPD isolates (n = 2,344; 2021-2022). Resistance to several β-lactam antimicrobials had increased significantly compared with 15 years before.ConclusionsThe NIPD isolates were strongly associated with non-vaccine serotypes and with increased AMR levels. This underlines the importance of continued NIPD surveillance for informed policy making on vaccination programmes.

Keywords: Streptococcus pneumoniae; antimicrobial resistance; non-invasive pneumococcal disease; protein conjugate vaccines; serotype.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Chloé Abels is an employee of MSD. None of the other authors has a conflict of interest to declare.

Figures

Figure 1
Figure 1
Age distribution of patients with non-invasive Streptococcus pneumoniae infection, Belgium, September 2020–April 2023 (n = 1,008)
Figure 2
Figure 2
Serotypes of Streptococcus pneumoniae isolates from patients with non-invasive infections, by clinical diagnosis and age, Belgium, September 2020–April 2023 (n = 1,023)
Figure 3
Figure 3
Antimicrobial resistance of Streptococcus pneumoniae isolates from patients with invasive infections, 2021–2022 (n = 2,344) and non-invasive infections, 2007–2008 (n = 448) and 2020–2022 (n = 539), Belgium
Figure 4
Figure 4
Serotypes of Streptococcus pneumoniae isolates from patients with invasive (n = 2,344) and non-invasive (n = 854) infections, Belgium, 2021–2022a
Figure 5
Figure 5
Age distribution and serotypes of patients with invasive (n = 2,344) and non-invasive (n = 854) Streptococcus pneumoniae infection, Belgium, 2021–2022a,b
See this image and copyright information in PMC

References

    1. Ikuta KS, Swetschinski LR, Robles Aguilar G, Sharara F, Mestrovic T, Gray AP, et al. . Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022;400(10369):2221-48. 10.1016/S0140-6736(22)02185-7 - DOI - PMC - PubMed
    1. Geno KA, Gilbert GL, Song JY, Skovsted IC, Klugman KP, Jones C, et al. Pneumococcal capsules and their types: past, present, and future. Clin Microbiol Rev. 2015;28(3):871-99. 10.1128/CMR.00024-15 - DOI - PMC - PubMed
    1. Feldman C, Anderson R. Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections. F1000 Res. 2020;9:338. 10.12688/f1000research.22341.1 - DOI - PMC - PubMed
    1. Hanquet G, Krizova P, Valentiner-Branth P, Ladhani SN, Nuorti JP, Lepoutre A, et al. Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination. Thorax. 2019;74(5):473-82. 10.1136/thoraxjnl-2018-211767 - DOI - PMC - PubMed
    1. Savulescu C, Krizova P, Valentiner-Branth P, Ladhani S, Rinta-Kokko H, Levy C, et al. Effectiveness of 10 and 13-valent pneumococcal conjugate vaccines against invasive pneumococcal disease in European children: SpIDnet observational multicentre study. Vaccine. 2022;40(29):3963-74. 10.1016/j.vaccine.2022.05.011 - DOI - PubMed

MeSH terms