Evolution of pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine

PLoS One. 2022 Jan 5;17(1):e0262225. doi: 10.1371/journal.pone.0262225. eCollection 2022.

Abstract

Pneumococcal conjugate vaccines reduce the burden of invasive pneumococcal disease, but the sustained effect of these vaccines can be diminished by an increase in disease caused by non-vaccine serotypes. To describe pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in July 2012, we performed molecular serotyping of 268 pneumococcal strains isolated from 221 children between 2012 and 2017. The median (interquartile range) age of the children included in this analysis was 6 (3,12) months. Fifty-nine percent of the children had received at least one dose of PCV-13 and 35% were fully vaccinated with PCV-13. While colonization by vaccine serotypes steadily declined following PCV-13 introduction, 25% of strains isolated more than 3 years after vaccine introduction were PCV-13 serotypes. We also observed an increase in colonization by non-vaccine serotypes 21 and 23B, which have been associated with invasive pneumococcal disease and antibiotic resistance in other settings.

MeSH terms

  • Bacterial Typing Techniques
  • Botswana / epidemiology
  • Female
  • Humans
  • Infant
  • Male
  • Nasopharynx / microbiology
  • Phylogeny
  • Pneumococcal Infections / epidemiology
  • Pneumococcal Infections / microbiology
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines / administration & dosage*
  • Pneumococcal Vaccines / pharmacology
  • Population Surveillance
  • Serotyping / methods*
  • Streptococcus pneumoniae / classification*
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / genetics

Substances

  • 13-valent pneumococcal vaccine
  • Pneumococcal Vaccines

Grants and funding

This research was supported by a Merck Investigator Studies Program Grant (MISP #59310 to M.S.K; URL: https://engagezone.msd.com/misp.php). S.M.P. was supported by a VECD Global Health Fellowship, funded by the Office of AIDS Research (OAR) and the Fogarty International Center (FIC) of the National Institutes of Health (NIH; D43 TW009337; URL: https://www.vumc.org/vecd/home). M.S.K. was supported by an Early Career Award from the Thrasher Research Fund (URL: https://www.thrasherresearch.org/early-career-award?lang=eng), a Burroughs Wellcome/American Society of Tropical Medicine and Hygiene Postdoctoral Fellowship in Tropical Infectious Diseases (URL: https://www.astmh.org/awards-fellowships-medals/awards-and-fellowships/burroughs-wellcome-fund-astmh-postdoctoral-fellows), an NIH Career Development Award (K23-AI135090; URL: https://www.niaid.nih.gov/grants-contracts/mentored-patient-oriented-research-career-development-award-k23), and a CIPHER grant from the International AIDS Society, supported by ViiV Healthcare (URL: https://www.iasociety.org/HIV-Programmes/Programmes/Paediatrics-CIPHER/CIPHER-Grant-Programme). The views expressed in this publication do not necessarily reflect the official policies of the International AIDS Society or ViiV Healthcare. M.S.K. and C.K.C. received financial support from the NIH through the Duke Center for AIDS Research (P30-AI064518; URL: https://cfar.duke.edu/). A.P.S and K.A.F received support from the Children’s Hospital of Philadelphia and A.P.S. and T.A-M. through core services from the Penn Center for AIDS Research, an NIH-funded program (P30-AI045008; URL https://www.med.upenn.edu/cfar/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.