Table 3.
GPSCs causing non-VT IPD in the PCV13 era
| Pooled incidence rate of non-VT IPD (95% CI)* | Number of non-VT isolates† | Mechanism 1‡ | Mechanism 2§ | Penicillin resistance, n (%) | Not susceptible to two or more classes of antibiotics, n (%) | |
|---|---|---|---|---|---|---|
| Ten most prevalent GPSCs causing non-VT IPD in the PCV13 era | ||||||
| GPSC3 | 2·70 (1·34–5·42) | 71 | 8 (South Africa)¶ | .. | 4 (6%) | 15 (21%) |
| GPSC19 | 0·89 (0·28–2·82) | 21 | .. | .. | 0 | 0 |
| GPSC11 | 0·86 (0·06–12·61) | 32 | .. | 19A→15B/C (Israel) | 1 (3%) | 1 (3%) |
| GPSC5 | 0·66 (0·27–1·62) | 28 | 35B/D (Malawi) | 23F→35B/D (South Africa)¶ | 26 (93%) | 24 (86%) |
| GPSC38 | 0·65 (0·11–3·94) | 17 | .. | .. | 0 | 0 |
| GPSC26 | 0·58 (0·21–1·58) | 35 | .. | .. | 0 | 35 (100%) |
| GPSC36 | 0·49 (0·20–1·22) | 12 | .. | .. | 0 | 0 |
| GPSC48 | 0·48 (0·12–1·97) | 11 | .. | .. | 11 (100%) | 7 (64%) |
| GPSC9 | 0·47 (0·05–4·00) | 13 | .. | .. | 13 (100%) | 13 (100%) |
| GPSC7 | 0·42 (0·07–2·64) | 10 | .. | .. | 0 | 0 |
| Other important GPSCs in the PCV13 era | ||||||
| GPSC59 | 0·32 (0·06–1·75) | 13 | 35B/D (USA) | .. | 13 (100%) | 10 (77%) |
| GPSC55 | 0·29 (0·00–80·15) | 65 | 12F (Israel) | .. | 65 (100%) | 0 |
| GPSC168 | 0·22 (0·09–0·50) | 5 | 15A (South Africa) | .. | 5 (100%) | 5 (100%) |
| GPSC25 | 0·21 (0·03–1·40) | 12 | 15B/C (South Africa) | .. | 0 | 0 |
| GPSC6 | 0·16 (0·03–0·82) | 8 | .. | 9V→15B/C (USA)¶ | 2 (25%) | 2 (25%) |
| GPSC139 | 0·16 (0·00–8·87) | 9 | 10B (Israel) | .. | 0 | 0 |
| GPSC132 | 0·12 (0·01–1·04) | 5 | 15B/C (USA)¶ | .. | 5 (100%) | 5 (100%) |
Serotypes with a significantly higher invasive disease potential (odds ratio for invasiveness >1, p value <0·05)18 were 8, 19A, and 12F. Serotypes with a significantly lower invasive disease potential (odds ratio for invasiveness <1, p value <0·05) were 15A, 15B/C, 23B, 21, and 35B. VT=vaccine serotype. IPD=invasive pneumococcal disease. PCV=pneumococcal conjugate vaccine. GPSC=Global Pneumococcal Sequence Cluster.
Calculated for Israel, South Africa, and the USA, where annual incidence of IPD was available; data are per 100 000 children.
Number of isolates from all six countries in the PCV13 period.
Increase in disease caused by non-VT GPSCs (ie, those expressing >50% non-vaccine serotypes in the pre-PCV13 period) in incidence for Israel, South Africa, and the USA, and in prevalence for Hong Kong, Malawi, and The Gambia.
Increase in non-VT component within VT-GPSCs (ie, those expressing ≥50% vaccine serotype in the pre-PCV period); data are presented as predominant serotype in the pre-PCV period → predominant serotype in the PCV13 period (country).
Significant increase was observed only between the PCV7 and PCV13 periods.