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dc.contributor.authorPichon, Bruno
dc.contributor.authorLadhani, Shamez N.
dc.contributor.authorSlack, Mary P. E.
dc.contributor.authorSegonds-Pichon, Anne
dc.contributor.authorAndrews, Nick J.
dc.contributor.authorWaight, Pauline A.
dc.contributor.authorMiller, Elizabeth
dc.contributor.authorGeorge, Robert
dc.date.accessioned2018-05-08T02:22:13Z
dc.date.available2018-05-08T02:22:13Z
dc.date.issued2013
dc.identifier.issn0095-1137en_US
dc.identifier.doi10.1128/JCM.01917-12en_US
dc.identifier.urihttp://hdl.handle.net/10072/172030
dc.description.abstractThe introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in September 2006 has markedly reduced the burden of invasive pneumococcal disease (IPD) including meningitis in England and Wales. This study examined changes in the molecular epidemiology of pneumococcal isolates causing meningitis from July 2004 to June 2009. The Health Protection Agency conducts enhanced pneumococcal surveillance in England and Wales. In addition to serotyping, pneumococcal isolates causing meningitis were genotyped by multilocus sequence typing (MLST). A total of 1,030 isolates were both serotyped and genotyped over the 5-year period. Fifty-two serotypes, 238 sequence types (STs), and 87 clonal complexes were identified, with no significant difference in the yearly Simpson's diversity index values (range, 0.974 to 0.984). STs commonly associated with PCV7 serotypes declined following PCV implementation, with a proportionally greater decline in ST124 (commonly associated with serotype 14). No other ST showed significant changes in distribution, even within individual serotypes. Replacement disease following PCV7 introduction was mainly due to serotypes 1, 3, 7F, 19A, 22F, and 33F through clonal expansion. A single instance of possible capsule switching was identified where one ST4327 clone expressed a serotype 14 capsule in 2005 and a serotype 28A capsule in 2009. In 2008 to 2009, ST191 (7F) became the most prevalent clone causing meningitis (10.3%). Case fatality (145 fatalities/1,030 cases; 14.1%) was high across all age groups and serotype groups. Thus, the introduction of PCV7 resulted in an increase in non-PCV7 serotypes, including some not covered by the 13-valent vaccine, such as serotypes 22F and 33F, emphasizing the importance of long-term epidemiological and molecular surveillance.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherAmerican Society for Microbiologyen_US
dc.relation.ispartofpagefrom820en_US
dc.relation.ispartofpageto827en_US
dc.relation.ispartofissue3en_US
dc.relation.ispartofjournalJournal of Clinical Microbiologyen_US
dc.relation.ispartofvolume51en_US
dc.subject.fieldofresearchClinical Microbiologyen_US
dc.subject.fieldofresearchcode110303en_US
dc.titleChanges in molecular epidemiology of Streptococcus Pneumoniae causing meningitis following introduction of pneumococcal conjugate vaccination in England and Walesen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
dc.description.versionPublisheden_US
gro.rights.copyright© 2013 American Society for Microbiology. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.en_US
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