Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study
The Lancet Infectious Diseases·
- DOI
- 10.1016/s1473-3099(19)30297-x
- PMID
- 31196809
- PMCID
- PMC7641901
- OpenAlex
- W2950614621
- Study type
- Genomic study
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Findings suggest emerging non-vaccine serotypes may be shaped by local antibiotic-selective pressures, highlighting the need for continued genomic surveillance to inform future vaccine design.
Structured evidence summary
Research question
The study investigated pneumococcal lineages associated with predominant serotypes, mechanisms of serotype replacement following pneumococcal conjugate vaccine introduction, and antibiotic resistance characteristics of major lineages in the post-vaccine era.
Study design
An international whole-genome sequencing study analyzing 3,233 invasive pneumococcal disease isolates from six countries, with comparison between pre-vaccine and post-vaccine periods to assess serotype replacement and lineage contributions.
Population and setting
Children younger than 3 years from Hong Kong, Israel, Malawi, South Africa, The Gambia, and the USA, with isolates from laboratory-based surveillance programs spanning before and after PCV introductions.
Main findings
The five most prevalent serotypes in the PCV13 period varied by country. Serotype replacement was driven primarily by expansion of non-vaccine serotypes within vaccine-type lineages, with GPSC3 identified as a globally spreading lineage. Significant increases in penicillin and erythromycin resistance were observed among non-vaccine serotype isolates in the post-vaccine period.
Public-health relevance
Findings suggest emerging non-vaccine serotypes may be shaped by local antibiotic-selective pressures, highlighting the need for continued genomic surveillance to inform future vaccine design.
Important limitations
No explicit limitations were stated in the supplied abstract. Conclusions are therefore limited to the information available in the abstract and require review of the full original paper for decision-grade interpretation.
GIDS interpretation
This genomic surveillance study of invasive pneumococcal disease isolates across multiple countries provides contextual data on serotype distribution and resistance patterns in the post-PCV era. The findings represent population-level surveillance evidence and do not constitute a signal requiring immediate action.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.