BACKGROUND: Widespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10; Synflorix, GSK) and 13-valent PCV (PCV13; Prevenar 13, Pfizer) globally. METHODS: IPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5-17 years, 18-49 years, and ≥50 years). FINDINGS: The analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3-12·9) of IPD cases in children younger than 5 years and 15·5% (13·4-19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2-65·4) and 45·6% (40·0-50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3-30·0) of IPD cases in children younger than 5 years and 29·5% (27·5-33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2-43·1]) and adults aged 50 years or older (14·8% [11·9-17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age and PCV10 or PCV13 strata, the proportion of IPD targeted by higher-valency PCVs beyond PCV13 was 4·1-9·7% for PCV15, 13·5-36·0% for PCV20, 29·9-53·8% for PCV21, 15·6-42·0% for PCV24, and 31·5-50·1% for PCV25. All top-ten ranked non-PCV13 serotypes are included in at least one higher-valency PCV. INTERPRETATION: The proportion of IPD due to serotypes included in PCVs in use was low in mature PCV10 and PCV13 settings. Serotype distribution differed between PCV10 and PCV13 sites and age groups. Higher-valency PCVs target most remaining IPD and are expected to extend impact. FUNDING: Bill & Melinda Gates Foundation as part of the WHO Pneumococcal Vaccines Technical Coordination Project.
- MeSH
- Global Health MeSH
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Immunization Programs MeSH
- Pneumococcal Infections * prevention & control epidemiology microbiology MeSH
- Pneumococcal Vaccines * administration & dosage MeSH
- Child, Preschool MeSH
- Aged MeSH
- Serogroup * MeSH
- Streptococcus pneumoniae * classification immunology MeSH
- Vaccines, Conjugate administration & dosage MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Child, Preschool MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Pneumococcal conjugate vaccines (PCVs) that are ten-valent (PCV10) and 13-valent (PCV13) became available in 2010. We evaluated their global impact on invasive pneumococcal disease (IPD) incidence in all ages. METHODS: Serotype-specific IPD cases and population denominators were obtained directly from surveillance sites using PCV10 or PCV13 in their national immunisation programmes and with a primary series uptake of at least 50%. Annual incidence rate ratios (IRRs) were estimated comparing the incidence before any PCV with each year post-PCV10 or post-PCV13 introduction using Bayesian multi-level, mixed-effects Poisson regressions, by site and age group. All site-weighted average IRRs were estimated using linear mixed-effects regression, stratified by product and previous seven-valent PCV (PCV7) effect (none, moderate, or substantial). FINDINGS: Analyses included 32 PCV13 sites (488 758 cases) and 15 PCV10 sites (46 386 cases) in 30 countries, primarily high income (39 sites), using booster dose schedules (41 sites). By 6 years after PCV10 or PCV13 introduction, IPD due to PCV10-type serotypes and PCV10-related serotype 6A declined substantially for both products (age <5 years: 83-99% decline; ≥65 years: 54-96% decline). PCV7-related serotype 19A increases before PCV10 or PCV13 introduction were reversed at PCV13 sites (age <5 years: 61-79% decline relative to before any PCV; age ≥65 years: 7-26% decline) but increased at PCV10 sites (age <5 years: 1·6-2·3-fold; age ≥65 years: 3·6-4·9-fold). Serotype 3 IRRs had no consistent trends for either product or age group. Non-PCV13-type IPD increased similarly for both products (age <5 years: 2·3-3·3-fold; age ≥65 years: 1·7-2·3-fold). Despite different serotype 19A trends, all-serotype IPD declined similarly between products among children younger than 5 years (58-74%); among adults aged 65 years or older, declines were greater at PCV13 (25-29%) than PCV10 (4-14%) sites, but other differences between sites precluded attribution to product. INTERPRETATION: Long-term use of PCV10 or PCV13 reduced IPD substantially in young children and more moderately in older ages. Non-vaccine-type serotypes increased approximately two-fold to three-fold by 6 years after introduction of PCV10 or PCV13. Continuing serotype 19A increases at PCV10 sites and declines at PCV13 sites suggest that PCV13 use would further reduce IPD at PCV10 sites. FUNDING: Bill & Melinda Gates Foundation as part of the WHO Pneumococcal Vaccines Technical Coordination Project.
- MeSH
- Global Health * MeSH
- Child MeSH
- Adult MeSH
- Incidence MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Pneumococcal Infections * prevention & control epidemiology MeSH
- Pneumococcal Vaccines * administration & dosage MeSH
- Child, Preschool MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Serogroup MeSH
- Streptococcus pneumoniae * classification immunology MeSH
- Vaccines, Conjugate administration & dosage MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: Despite national guidelines and use of intrapartum antibiotic prophylaxis (IAP), Streptococcus agalactiae (group B streptococci (GBS)) is still a leading cause of morbidity and mortality in newborns in Europe and the United States. The European DEVANI (Design of a Vaccine Against Neonatal Infections) program assessed the neonatal GBS infection burden in Europe, the clinical characteristics of colonized women and microbiological data of GBS strains in colonized women and their infants with early-onset disease (EOD). METHODS: Overall, 1083 pregnant women with a GBS-positive culture result from eight European countries were included in the study. Clinical obstetrical information was collected by a standardized questionnaire. GBS strains were characterized by serological and molecular methods. RESULTS: Among GBS carriers included in this study after testing positive for GBS by vaginal or recto-vaginal sampling, 13.4% had at least one additional obstetrical risk factor for EOD. The five most common capsular types (i.e., Ia, Ib, II, III and V) comprised ~ 93% of GBS carried. Of the colonized women, 77.8% received any IAP, and in 49.5% the IAP was considered appropriate. In our cohort, nine neonates presented with GBS early-onset disease (EOD) with significant regional heterogeneity. CONCLUSIONS: Screening methods and IAP rates need to be harmonized across Europe in order to reduce the rates of EOD. The epidemiological data from eight different European countries provides important information for the development of a successful GBS vaccine.
- MeSH
- Antibiotic Prophylaxis MeSH
- Adult MeSH
- Pregnancy Complications, Infectious * epidemiology microbiology MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Carrier State epidemiology microbiology MeSH
- Streptococcus agalactiae * isolation & purification classification MeSH
- Streptococcal Infections * epidemiology microbiology prevention & control MeSH
- Pregnancy MeSH
- Vagina microbiology MeSH
- Infectious Disease Transmission, Vertical statistics & numerical data prevention & control MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Since 2022, an increasing number of invasive group A streptococcal (iGAS) infections have been reported, with increasing severity and lethality. We aimed to compare the frequency and characteristics of bacteraemic GAS infections in adults before and after the COVID-19 pandemic. METHODS: This was a retrospective observational study of adult patients with Streptococcus pyogenes bacteraemia in two periods, January 2017 to December 2019 and October 2022 to December 2023. Demographics, clinical presentation, antibiotic treatment, therapeutic response, complications and outcome were analysed. RESULTS: Thirty-five patients with Streptococcus pyogenes bacteraemia in the 3-year pre-pandemic group were compared with 36 patients in the 15-month post-pandemic group. The median ages in the pre-pandemic and post-pandemic groups were 65 (IQR = 28) and 64.5 (IQR = 31) years, respectively. The proportions of males and females in the pre-pandemic group were 69% and 31%, respectively, compared with 33% and 67%, respectively, in the post-pandemic group. Skin and soft tissue infections occurred in 77% and 53%, respectively (p = 0.032). Rare manifestations, such as pneumonia and meningitis, were diagnosed in the post-pandemic group. Septic shock was significantly less common in the pre-pandemic group, with rates of 26% vs. 56% (p = 0.011). Treatment response was good in 74% of the pre-pandemic group compared to 58% of the post-pandemic group (p = 0.155). Lethality was not significantly higher in the post-pandemic group (26% vs. 33%, p = 0.482) but the number of deaths per year was more than three times higher in the post-pandemic group. CONCLUSIONS: In the post-pandemic period, the frequency of bacteraemic GAS infections in adults increased significantly. A higher proportion of women, a decrease in the age of women and an increase in the age of men, rare clinical manifestations, poor response to therapy and increased severity and number of deaths were the new features of adult disease observed in the post-pandemic period.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Bacteremia * epidemiology microbiology drug therapy MeSH
- COVID-19 * epidemiology MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Retrospective Studies MeSH
- SARS-CoV-2 MeSH
- Aged MeSH
- Streptococcus pyogenes * MeSH
- Streptococcal Infections * epidemiology drug therapy microbiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
BACKGROUND AND OBJECTIVE: Microbial selenium (Se) supplementation is an essential area of biotechnological research due to differences in the bioavailability and toxicity of different forms of selenium. To date, research has focused mainly on the use of selenized yeast. However, in recent years, scientific interest has also increased in other microorganisms, such as lactic acid bacteria (LAB), which have several unique properties that can affect the quality and bioavailability of selenium. LAB, unlike yeast, can also act as probiotics, which may bring additional health benefits related to improving the intestinal microbiota and supporting the health of the gastrointestinal tract. METHODS: This study investigates the in vitro bioaccessibility and bioavailability of Se from two lactic acid bacterial strains, Streptococcus thermophilus CCDM 144 and Enterococcus faecium CCDM 922 A. We evaluated Se accumulation, speciation, and stability during simulated gastrointestinal digestion and Se permeation through a Caco-2 cell monolayer model. RESULTS: Both strains accumulated Se, metabolizing it predominantly into selenium nanoparticles (SeNPs, 64-77 % of total Se), with only a minor fraction (<5 % of total Se) of organic Se species. Experiments revealed that while organic Se species had high bioavailability (up to 90 %), their bioaccessibility during digestion was very low (<0.1 % of total Se). In contrast, SeNPs showed high bioaccessibility (∼90 %) and moderate transport efficiency through the intestinal model (16-19 % after 4 hours). CONCLUSION: These results highlight the potential of SeNPs produced by lactic acid bacteria as a bioaccessible form of Se for dietary supplementation. Further research is required to explore the behavior of SeNPs within the human body to fully understand how they can be used safely and effectively in nutrition or other applications.
- MeSH
- Biological Availability * MeSH
- Models, Biological MeSH
- Caco-2 Cells MeSH
- Intestinal Barrier Function MeSH
- Lactobacillales metabolism MeSH
- Humans MeSH
- Permeability MeSH
- Selenium * metabolism MeSH
- Streptococcus thermophilus metabolism MeSH
- Digestion MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
UNLABELLED: The paper presents the study of a set of isolates of Streptococcus pneumoniae, which comprised two heterogeneous subpopulations, one of which was susceptible and the other resistant to optochin. The aim of the study was to compare the results of serotyping, multilocus sequence typing (MLST), ribosomal multilocus sequence typing (rMLST), and variation analysis of these subpopulations and to investigate the genetic probable causes of optochin resistance. The strains studied were cultured from samples taken from patients with invasive pneumococcal disease in the Czech Republic in 2019 and 2020. A total of 10 studied pairs of isolates were subject to serotyping and whole-genome sequencing (WGS). None of the typing methods (serotyping, MLST, or rMLST) applied to pairs of optochin-susceptible and optochin-resistant isolates revealed differences in serotype, sequence type, or ribosomal sequence type. The WGS data analysis identified point mutations in ATP (adenosine triphosphate) synthase genes in 8 of the 10 optochin-resistant isolates. In seven optochin-resistant isolates, the mutation was found in the atpC gene and in one isolate in the atpA gene. One of the mutations in the atpC gene has not yet been published in the literature; it is a mutation at position 143T > C with an amino acid change of Val48Ala. In 8 out of the 10 optochin-resistant isolates, the possible genetic basis for resistance was identified, involving point mutations in the atpA and atpC genes. In the remaining two isolates, no clear genetic explanation for the optochin resistance in S. pneumoniae was found, based on current knowledge. IMPORTANCE: Globally, among the most fundamental tests used for the identification of Streptococcus pneumoniae isolates is determining susceptibility to optochin. In the last 2 decades, optochin-resistant strains have been frequently reported in the literature, which can lead to the misidentification of S. pneumoniae. This study compares whole-genome sequencing data of optochin-susceptible and optochin-resistant subpopulations of S. pneumoniae isolates and investigates the genetic probable causes of resistance in the genomes of optochin-resistant subpopulations.
- MeSH
- Anti-Bacterial Agents * pharmacology MeSH
- Drug Resistance, Bacterial * genetics MeSH
- Bacterial Proteins genetics MeSH
- Quinine analogs & derivatives MeSH
- Genome, Bacterial MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Multilocus Sequence Typing MeSH
- Pneumococcal Infections microbiology MeSH
- Whole Genome Sequencing MeSH
- Serotyping MeSH
- Streptococcus pneumoniae * genetics drug effects isolation & purification classification MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Anti-Bacterial Agents administration & dosage therapeutic use MeSH
- Humans MeSH
- Young Adult MeSH
- Pneumococcal Infections * diagnosis drug therapy prevention & control MeSH
- Pneumococcal Vaccines administration & dosage therapeutic use MeSH
- Pneumonia, Pneumococcal diagnosis drug therapy MeSH
- Streptococcus pneumoniae MeSH
- Vaccination MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Parapharyngeal abscess in an infant is a very rare condition. We present the case of a 4-month-old girl with large masses on the neck's left side. Computed tomography showed an extensive parapharyngeal abscess. Left tonsillectomy was performed under general anesthesia from a transoral approach, followed by an incision and evacuation of the abscess from the parapharyngeal space. Microbiological analysis identified a massive occurrence of Streptococcus intermedius.
- MeSH
- Abscess * microbiology surgery MeSH
- Infant MeSH
- Humans MeSH
- Pharyngeal Diseases microbiology surgery MeSH
- Tomography, X-Ray Computed MeSH
- Parapharyngeal Space * surgery diagnostic imaging microbiology MeSH
- Streptococcus intermedius isolation & purification MeSH
- Streptococcal Infections * microbiology surgery MeSH
- Tonsillectomy MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
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x
- MeSH
- Genotyping Techniques MeSH
- Disease Notification MeSH
- Humans MeSH
- Streptococcus pyogenes * isolation & purification pathogenicity MeSH
- Streptococcal Infections * epidemiology MeSH
- Age Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Chart MeSH
- Geographicals
- Czech Republic MeSH
