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Global distribution of invasive serotype 35D streptococcus pneumoniae isolates following introduction of 13-valent pneumococcal conjugate vaccine

Global distribution of invasive serotype 35D streptococcus pneumoniae isolates following introduction of 13-valent pneumococcal conjugate vaccine
Global distribution of invasive serotype 35D streptococcus pneumoniae isolates following introduction of 13-valent pneumococcal conjugate vaccine

A newly recognized pneumococcal serotype, 35D, which differs from the 35B polysaccharide in structure and serology by not binding to factor serum 35a, was recently reported. The genetic basis for this distinctive serology is due to the presence of an inactivating mutation in wciG, which encodes an O-acetyltransferase responsible for O-acetylation of a galactofuranose. Here, we assessed the genomic data of a worldwide pneumococcal collection to identify serotype 35D isolates and understand their geographical distribution, genetic background, and invasiveness potential. Of 21,980 pneumococcal isolates, 444 were originally typed as se-rotype 35B by PneumoCaT. Analysis of the wciG gene revealed 23 isolates from carriage (n= 4) and disease (n= 19) with partial or complete loss-of-function mutations, including mutations resulting in premature stop codons (n= 22) and an inframe mutation (n= 1). These were selected for further analysis. The putative 35D isolates were geographically widespread, and 65.2% (15/23) of them was recovered after the introduction of pneumococcal conjugate vaccine 13 (PCV13). Compared with serotype 35B isolates, putative serotype 35D isolates have higher invasive disease potentials based on odds ratios (OR) (11.58; 95% confidence interval[CI], 1.42 to 94.19 versus 0.61; 95% CI, 0.40 to 0.92) and a higher prevalence of macrolide resistance mediated by mefA (26.1% versus 7.6%; P= 0.009). Using the Quellung reaction, 50% (10/20) of viable isolates were identified as serotype 35D, 25% (5/20) as serotype 35B, and 25% (5/20) as a mixture of 35B/35D. The discrepancy between phenotype and genotype requires further investigation. These findings illustrated a global distribution of an invasive serotype, 35D, among young children post-PCV13 introduction and underlined the invasive potential conferred by the loss of Oacetylation in the pneumococcal capsule.

35D, Novel serotype, PCV, Whole-genome sequencing
0095-1137
Lo, Stephanie W.
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Gladstone, Rebecca A.
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Van Tonder, Andries J.
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Hawkins, Paulina A.
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Kwambana-Adams, Brenda
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Cornick, Jennifer E.
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Madhi, Shabir A.
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Nzenze, Susan A.
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Du Plessis, Mignon
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Kandasamy, Rama
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Carter, Philip E.
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Eser, Özgen Köseoglu
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Ho, Pak Leung
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Elmdaghri, Naima
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Shakoor, Sadia
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Clarke, Stuart C.
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Antonio, Martin
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Everett, Dean B.
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Von Gottberg, Anne
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Klugman, Keith P.
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McGee, Lesley
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Breiman, Robert F.
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Bentley, Stephen D.
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Lo, Stephanie W.
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Gladstone, Rebecca A.
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Van Tonder, Andries J.
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Hawkins, Paulina A.
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Kwambana-Adams, Brenda
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Cornick, Jennifer E.
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Madhi, Shabir A.
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Nzenze, Susan A.
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Du Plessis, Mignon
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Kandasamy, Rama
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Carter, Philip E.
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Eser, Özgen Köseoglu
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Ho, Pak Leung
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Elmdaghri, Naima
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Shakoor, Sadia
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Clarke, Stuart C.
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Antonio, Martin
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Everett, Dean B.
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Von Gottberg, Anne
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Klugman, Keith P.
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McGee, Lesley
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Breiman, Robert F.
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Bentley, Stephen D.
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Lo, Stephanie W., Gladstone, Rebecca A., Van Tonder, Andries J., Hawkins, Paulina A., Kwambana-Adams, Brenda, Cornick, Jennifer E., Madhi, Shabir A., Nzenze, Susan A., Du Plessis, Mignon, Kandasamy, Rama, Carter, Philip E., Eser, Özgen Köseoglu, Ho, Pak Leung, Elmdaghri, Naima, Shakoor, Sadia, Clarke, Stuart C., Antonio, Martin, Everett, Dean B., Von Gottberg, Anne, Klugman, Keith P., McGee, Lesley, Breiman, Robert F. and Bentley, Stephen D. (2018) Global distribution of invasive serotype 35D streptococcus pneumoniae isolates following introduction of 13-valent pneumococcal conjugate vaccine. Journal of Clinical Microbiology, 56 (7). (doi:10.1128/JCM.00228-18).

Record type: Article

Abstract

A newly recognized pneumococcal serotype, 35D, which differs from the 35B polysaccharide in structure and serology by not binding to factor serum 35a, was recently reported. The genetic basis for this distinctive serology is due to the presence of an inactivating mutation in wciG, which encodes an O-acetyltransferase responsible for O-acetylation of a galactofuranose. Here, we assessed the genomic data of a worldwide pneumococcal collection to identify serotype 35D isolates and understand their geographical distribution, genetic background, and invasiveness potential. Of 21,980 pneumococcal isolates, 444 were originally typed as se-rotype 35B by PneumoCaT. Analysis of the wciG gene revealed 23 isolates from carriage (n= 4) and disease (n= 19) with partial or complete loss-of-function mutations, including mutations resulting in premature stop codons (n= 22) and an inframe mutation (n= 1). These were selected for further analysis. The putative 35D isolates were geographically widespread, and 65.2% (15/23) of them was recovered after the introduction of pneumococcal conjugate vaccine 13 (PCV13). Compared with serotype 35B isolates, putative serotype 35D isolates have higher invasive disease potentials based on odds ratios (OR) (11.58; 95% confidence interval[CI], 1.42 to 94.19 versus 0.61; 95% CI, 0.40 to 0.92) and a higher prevalence of macrolide resistance mediated by mefA (26.1% versus 7.6%; P= 0.009). Using the Quellung reaction, 50% (10/20) of viable isolates were identified as serotype 35D, 25% (5/20) as serotype 35B, and 25% (5/20) as a mixture of 35B/35D. The discrepancy between phenotype and genotype requires further investigation. These findings illustrated a global distribution of an invasive serotype, 35D, among young children post-PCV13 introduction and underlined the invasive potential conferred by the loss of Oacetylation in the pneumococcal capsule.

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J. Clin. Microbiol.-2018-Lo- - Version of Record
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Accepted/In Press date: 24 April 2018
e-pub ahead of print date: 2 May 2018
Published date: 1 July 2018
Keywords: 35D, Novel serotype, PCV, Whole-genome sequencing

Identifiers

Local EPrints ID: 422114
URI: http://eprints.soton.ac.uk/id/eprint/422114
ISSN: 0095-1137
PURE UUID: 12b57c8d-3c7e-4c34-b8de-26014cbfef51
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 17 Jul 2018 16:30
Last modified: 24 Feb 2021 02:39

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Contributors

Author: Stephanie W. Lo
Author: Rebecca A. Gladstone
Author: Andries J. Van Tonder
Author: Paulina A. Hawkins
Author: Brenda Kwambana-Adams
Author: Jennifer E. Cornick
Author: Shabir A. Madhi
Author: Susan A. Nzenze
Author: Mignon Du Plessis
Author: Rama Kandasamy
Author: Philip E. Carter
Author: Özgen Köseoglu Eser
Author: Pak Leung Ho
Author: Naima Elmdaghri
Author: Sadia Shakoor
Author: Martin Antonio
Author: Dean B. Everett
Author: Anne Von Gottberg
Author: Keith P. Klugman
Author: Lesley McGee
Author: Robert F. Breiman
Author: Stephen D. Bentley

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