Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data

Chrispin Chaguza; Ellen Heinsbroek; Rebecca A. Gladstone; Terence Tafatatha; Maaike Alaerts; Chikondi Peno; Jennifer E. Cornick; Patrick Musicha; Naor Bar-Zeev; Arox Kamng'Ona; Aras Kadioglu; Lesley McGee; William P. Hanage; Robert F. Breiman; Robert S. Heyderman; Neil French; Dean B. Everett; Stephen D. Bentley

doi:10.1093/cid/ciz404

Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data

Chrispin Chaguza^*, Ellen Heinsbroek, Rebecca A. Gladstone, Terence Tafatatha, Maaike Alaerts, Chikondi Peno, Jennifer E. Cornick, Patrick Musicha, Naor Bar-Zeev, Arox Kamng'Ona, Aras Kadioglu, Lesley McGee, William P. Hanage, Robert F. Breiman, Robert S. Heyderman, Neil French, Dean B. Everett, Stephen D. Bentley

^*Corresponding author for this work

Field Epidemiology (East Of England)

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background: Pneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. Pneumococcal genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. Methods: We undertook whole-genome sequencing (WGS) of 660 pneumococcal isolates collected through surveys from healthy carriers 2 years from 13-valent PCV (PCV13) introduction and 1 year after rollout in northern Malawi. We investigated changes in population structure, within-lineage serotype dynamics, serotype diversity, and frequency of antibiotic resistance (ABR) and accessory genes. Results: In children <5 years of age, frequency and diversity of vaccine serotypes (VTs) decreased significantly post-PCV, but no significant changes occurred in persons ≥5 years of age. Clearance of VT serotypes was consistent across different genetic backgrounds (lineages). There was an increase of nonvaccine serotypes (NVTs) - namely 7C, 15B/C, and 23A - in children <5 years of age, but 28F increased in both age groups. While carriage rates have been recently shown to remain stable post-PCV due to replacement serotypes, there was no change in diversity of NVTs. Additionally, frequency of intermediate-penicillin-resistant lineages decreased post-PCV. Although frequency of ABR genes remained stable, other accessory genes, especially those associated with mobile genetic element and bacteriocins, showed changes in frequency post-PCV. Conclusions: We demonstrate evidence of significant population restructuring post-PCV driven by decreasing frequency of vaccine serotypes and increasing frequency of few NVTs mainly in children under 5. Continued surveillance with WGS remains crucial to fully understand dynamics of the residual VTs and replacement NVT serotypes post-PCV.

Original language	English
Pages (from-to)	1294-1303
Number of pages	10
Journal	Clinical Infectious Diseases
Volume	70
Issue number	7
DOIs	https://doi.org/10.1093/cid/ciz404
Publication status	Published - 17 Mar 2020

Bibliographical note

Funding Information:
Potential conflicts of interest. N. B. Z. has received investigator-initiated project grants from GlaxoSmithKline Biologicals and from Takeda Pharmaceuticals. R. A. G. has received a PhD studentship from Pfizer in 2009–2013. W. P. H. has received personal fees from Antigen Discovery. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Funding Information:
Financial support. This work was supported by the Bill & Melinda Gates Foundation’s funding for the Global Pneumococcal Sequencing (GPS) project (www.pneumogen.net; grant number OPP1034556 to S. D. B., L. M., and R. F. B.) and by Wellcome UK (core grant number 084679/Z/08/Z to the MLW). R. S. H. and N. F. are supported by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) grant under the MRC/DFID Concordat agreement and is also part of the EDCTP2 program supported by the European Union (MR/N023129/1). C. C. was funded by a PhD studentship from the Commonwealth Scholarship Commission in the United Kingdom.

Publisher Copyright:
© 2019 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.

Keywords

carriage
genomics
pneumococcus
serotypes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciz404

Cite this

Chaguza, C., Heinsbroek, E., Gladstone, R. A., Tafatatha, T., Alaerts, M., Peno, C., Cornick, J. E., Musicha, P., Bar-Zeev, N., Kamng'Ona, A., Kadioglu, A., McGee, L., Hanage, W. P., Breiman, R. F., Heyderman, R. S., French, N., Everett, D. B., & Bentley, S. D. (2020). Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data. Clinical Infectious Diseases, 70(7), 1294-1303. https://doi.org/10.1093/cid/ciz404

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title = "Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data",

abstract = "Background: Pneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. Pneumococcal genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. Methods: We undertook whole-genome sequencing (WGS) of 660 pneumococcal isolates collected through surveys from healthy carriers 2 years from 13-valent PCV (PCV13) introduction and 1 year after rollout in northern Malawi. We investigated changes in population structure, within-lineage serotype dynamics, serotype diversity, and frequency of antibiotic resistance (ABR) and accessory genes. Results: In children <5 years of age, frequency and diversity of vaccine serotypes (VTs) decreased significantly post-PCV, but no significant changes occurred in persons ≥5 years of age. Clearance of VT serotypes was consistent across different genetic backgrounds (lineages). There was an increase of nonvaccine serotypes (NVTs) - namely 7C, 15B/C, and 23A - in children <5 years of age, but 28F increased in both age groups. While carriage rates have been recently shown to remain stable post-PCV due to replacement serotypes, there was no change in diversity of NVTs. Additionally, frequency of intermediate-penicillin-resistant lineages decreased post-PCV. Although frequency of ABR genes remained stable, other accessory genes, especially those associated with mobile genetic element and bacteriocins, showed changes in frequency post-PCV. Conclusions: We demonstrate evidence of significant population restructuring post-PCV driven by decreasing frequency of vaccine serotypes and increasing frequency of few NVTs mainly in children under 5. Continued surveillance with WGS remains crucial to fully understand dynamics of the residual VTs and replacement NVT serotypes post-PCV.",

keywords = "carriage, genomics, pneumococcus, serotypes",

author = "Chrispin Chaguza and Ellen Heinsbroek and Gladstone, {Rebecca A.} and Terence Tafatatha and Maaike Alaerts and Chikondi Peno and Cornick, {Jennifer E.} and Patrick Musicha and Naor Bar-Zeev and Arox Kamng'Ona and Aras Kadioglu and Lesley McGee and Hanage, {William P.} and Breiman, {Robert F.} and Heyderman, {Robert S.} and Neil French and Everett, {Dean B.} and Bentley, {Stephen D.}",

note = "Funding Information: Potential conflicts of interest. N. B. Z. has received investigator-initiated project grants from GlaxoSmithKline Biologicals and from Takeda Pharmaceuticals. R. A. G. has received a PhD studentship from Pfizer in 2009–2013. W. P. H. has received personal fees from Antigen Discovery. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Funding Information: Financial support. This work was supported by the Bill & Melinda Gates Foundation{\textquoteright}s funding for the Global Pneumococcal Sequencing (GPS) project (www.pneumogen.net; grant number OPP1034556 to S. D. B., L. M., and R. F. B.) and by Wellcome UK (core grant number 084679/Z/08/Z to the MLW). R. S. H. and N. F. are supported by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) grant under the MRC/DFID Concordat agreement and is also part of the EDCTP2 program supported by the European Union (MR/N023129/1). C. C. was funded by a PhD studentship from the Commonwealth Scholarship Commission in the United Kingdom. Publisher Copyright: {\textcopyright} 2019 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.",

year = "2020",

month = mar,

day = "17",

doi = "10.1093/cid/ciz404",

language = "English",

volume = "70",

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Chaguza, C, Heinsbroek, E, Gladstone, RA, Tafatatha, T, Alaerts, M, Peno, C, Cornick, JE, Musicha, P, Bar-Zeev, N, Kamng'Ona, A, Kadioglu, A, McGee, L, Hanage, WP, Breiman, RF, Heyderman, RS, French, N, Everett, DB & Bentley, SD 2020, 'Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data', Clinical Infectious Diseases, vol. 70, no. 7, pp. 1294-1303. https://doi.org/10.1093/cid/ciz404

TY - JOUR

T1 - Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data

AU - Chaguza, Chrispin

AU - Heinsbroek, Ellen

AU - Gladstone, Rebecca A.

AU - Tafatatha, Terence

AU - Alaerts, Maaike

AU - Peno, Chikondi

AU - Cornick, Jennifer E.

AU - Musicha, Patrick

AU - Bar-Zeev, Naor

AU - Kamng'Ona, Arox

AU - Kadioglu, Aras

AU - McGee, Lesley

AU - Hanage, William P.

AU - Breiman, Robert F.

AU - Heyderman, Robert S.

AU - French, Neil

AU - Everett, Dean B.

AU - Bentley, Stephen D.

N1 - Funding Information: Potential conflicts of interest. N. B. Z. has received investigator-initiated project grants from GlaxoSmithKline Biologicals and from Takeda Pharmaceuticals. R. A. G. has received a PhD studentship from Pfizer in 2009–2013. W. P. H. has received personal fees from Antigen Discovery. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Funding Information: Financial support. This work was supported by the Bill & Melinda Gates Foundation’s funding for the Global Pneumococcal Sequencing (GPS) project (www.pneumogen.net; grant number OPP1034556 to S. D. B., L. M., and R. F. B.) and by Wellcome UK (core grant number 084679/Z/08/Z to the MLW). R. S. H. and N. F. are supported by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) grant under the MRC/DFID Concordat agreement and is also part of the EDCTP2 program supported by the European Union (MR/N023129/1). C. C. was funded by a PhD studentship from the Commonwealth Scholarship Commission in the United Kingdom. Publisher Copyright: © 2019 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.

PY - 2020/3/17

Y1 - 2020/3/17

N2 - Background: Pneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. Pneumococcal genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. Methods: We undertook whole-genome sequencing (WGS) of 660 pneumococcal isolates collected through surveys from healthy carriers 2 years from 13-valent PCV (PCV13) introduction and 1 year after rollout in northern Malawi. We investigated changes in population structure, within-lineage serotype dynamics, serotype diversity, and frequency of antibiotic resistance (ABR) and accessory genes. Results: In children <5 years of age, frequency and diversity of vaccine serotypes (VTs) decreased significantly post-PCV, but no significant changes occurred in persons ≥5 years of age. Clearance of VT serotypes was consistent across different genetic backgrounds (lineages). There was an increase of nonvaccine serotypes (NVTs) - namely 7C, 15B/C, and 23A - in children <5 years of age, but 28F increased in both age groups. While carriage rates have been recently shown to remain stable post-PCV due to replacement serotypes, there was no change in diversity of NVTs. Additionally, frequency of intermediate-penicillin-resistant lineages decreased post-PCV. Although frequency of ABR genes remained stable, other accessory genes, especially those associated with mobile genetic element and bacteriocins, showed changes in frequency post-PCV. Conclusions: We demonstrate evidence of significant population restructuring post-PCV driven by decreasing frequency of vaccine serotypes and increasing frequency of few NVTs mainly in children under 5. Continued surveillance with WGS remains crucial to fully understand dynamics of the residual VTs and replacement NVT serotypes post-PCV.

AB - Background: Pneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. Pneumococcal genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. Methods: We undertook whole-genome sequencing (WGS) of 660 pneumococcal isolates collected through surveys from healthy carriers 2 years from 13-valent PCV (PCV13) introduction and 1 year after rollout in northern Malawi. We investigated changes in population structure, within-lineage serotype dynamics, serotype diversity, and frequency of antibiotic resistance (ABR) and accessory genes. Results: In children <5 years of age, frequency and diversity of vaccine serotypes (VTs) decreased significantly post-PCV, but no significant changes occurred in persons ≥5 years of age. Clearance of VT serotypes was consistent across different genetic backgrounds (lineages). There was an increase of nonvaccine serotypes (NVTs) - namely 7C, 15B/C, and 23A - in children <5 years of age, but 28F increased in both age groups. While carriage rates have been recently shown to remain stable post-PCV due to replacement serotypes, there was no change in diversity of NVTs. Additionally, frequency of intermediate-penicillin-resistant lineages decreased post-PCV. Although frequency of ABR genes remained stable, other accessory genes, especially those associated with mobile genetic element and bacteriocins, showed changes in frequency post-PCV. Conclusions: We demonstrate evidence of significant population restructuring post-PCV driven by decreasing frequency of vaccine serotypes and increasing frequency of few NVTs mainly in children under 5. Continued surveillance with WGS remains crucial to fully understand dynamics of the residual VTs and replacement NVT serotypes post-PCV.

KW - carriage

KW - genomics

KW - pneumococcus

KW - serotypes

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U2 - 10.1093/cid/ciz404

DO - 10.1093/cid/ciz404

M3 - Article

C2 - 31094423

AN - SCOPUS:85082096197

SN - 1058-4838

VL - 70

SP - 1294

EP - 1303

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 7

ER -

Early signals of vaccine-driven perturbation seen in pneumococcal carriage population genomic data

Abstract

Bibliographical note

Keywords

UN SDGs

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