Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014

C. Sheppard; Norman Fry; Shazad Mushtaq; Neil Woodford; R. Reynolds; R. Janes; Rachel Pike; Robert Hill; M. Kimuli; P. Staves; Michel Doumith; Timothy Harrison; David Livermore

doi:10.2807/1560-7917.ES.2016.21.50.30423

Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014

C. Sheppard
, Norman Fry
, Shazad Mushtaq
, Neil Woodford
, R. Reynolds
, R. Janes
, Rachel Pike
, Robert Hill
, M. Kimuli
, P. Staves
, Michel Doumith
, Timothy Harrison
, David Livermore^*

^*Corresponding author for this work

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

55 Citations (Scopus)

Abstract

Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001-2014; (ii) Public Health England’s (PHE) invasive isolate surveillance from 2005-2014 and (iii) referral to PHE for resistance investigation from 2005-2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin. 15A was consistently among the 10 most prevalent serotypes from 2011 in PHE and BSAC invasive isolate/bacteraemia surveillance but never previously; 26-33% of these invasive 15A isolates had triple resistance. BSAC respiratory isolates were only serotyped in 2013/14 and 2014/15 (October to September); 15A was most prevalent serotype in both periods, comprising 9-11% of isolates, 38-48% of them with triple resistance. Serotype 15A represented 0-4% of S. pneumoniae referred to PHE for reference investigation annually until 2008 but rose to 29% (2013) and 32% (2014). Almost all multidrug- resistant 15A isolates were sequence type (ST) 63 variants, whereas susceptible 15A isolates were clonally diverse. The rise of serotype 15A suggests that pneumococcal conjugate vaccines will need ongoing adaptation.

Original language	English
Journal	Eurosurveillance
Volume	21
Issue number	50
DOIs	https://doi.org/10.2807/1560-7917.ES.2016.21.50.30423
Publication status	Published - 15 Dec 2016

Bibliographical note

Funding Information:
A considerable number of people have contributed to the success of this study. We are grateful to Dr Elizabeth Miller of Public Health England?s (PHE) Immunisation Division, and to the members of the British Society for Antimicrobial Chemotherapy?s Resistance Surveillance Standing Committee for helpful discussion. We are also grateful to Tony McNiff for help in data extraction and analysis and to the many PHE staff who undertook laboratory testing of these isolates, also to the NHS and Irish laboratories that have contributed isolates and data to the various surveillance programmes used here. This publication made use of the Streptococcus pneumoniae MLST website (http://pubmlst.org/spneumoniae/) sited at the University of Oxford [29]. The development of this site has been funded by the Wellcome Trust.

Publisher Copyright:
© 2016, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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

SDG 3 Good Health and Well-being

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10.2807/1560-7917.ES.2016.21.50.30423

Cite this

@article{a95caaec6f714f30ad480a39b48258f1,

title = "Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014",

abstract = "Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001-2014; (ii) Public Health England{\textquoteright}s (PHE) invasive isolate surveillance from 2005-2014 and (iii) referral to PHE for resistance investigation from 2005-2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin. 15A was consistently among the 10 most prevalent serotypes from 2011 in PHE and BSAC invasive isolate/bacteraemia surveillance but never previously; 26-33\% of these invasive 15A isolates had triple resistance. BSAC respiratory isolates were only serotyped in 2013/14 and 2014/15 (October to September); 15A was most prevalent serotype in both periods, comprising 9-11\% of isolates, 38-48\% of them with triple resistance. Serotype 15A represented 0-4\% of S. pneumoniae referred to PHE for reference investigation annually until 2008 but rose to 29\% (2013) and 32\% (2014). Almost all multidrug- resistant 15A isolates were sequence type (ST) 63 variants, whereas susceptible 15A isolates were clonally diverse. The rise of serotype 15A suggests that pneumococcal conjugate vaccines will need ongoing adaptation.",

author = "C. Sheppard and Norman Fry and Shazad Mushtaq and Neil Woodford and R. Reynolds and R. Janes and Rachel Pike and Robert Hill and M. Kimuli and P. Staves and Michel Doumith and Timothy Harrison and David Livermore",

note = "Funding Information: A considerable number of people have contributed to the success of this study. We are grateful to Dr Elizabeth Miller of Public Health England?s (PHE) Immunisation Division, and to the members of the British Society for Antimicrobial Chemotherapy?s Resistance Surveillance Standing Committee for helpful discussion. We are also grateful to Tony McNiff for help in data extraction and analysis and to the many PHE staff who undertook laboratory testing of these isolates, also to the NHS and Irish laboratories that have contributed isolates and data to the various surveillance programmes used here. This publication made use of the Streptococcus pneumoniae MLST website (http://pubmlst.org/spneumoniae/) sited at the University of Oxford [29]. The development of this site has been funded by the Wellcome Trust. Publisher Copyright: {\textcopyright} 2016, European Centre for Disease Prevention and Control (ECDC). All rights reserved.",

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AU - Sheppard, C.

AU - Fry, Norman

AU - Mushtaq, Shazad

AU - Woodford, Neil

AU - Reynolds, R.

AU - Janes, R.

AU - Pike, Rachel

AU - Hill, Robert

AU - Kimuli, M.

AU - Staves, P.

AU - Doumith, Michel

AU - Harrison, Timothy

AU - Livermore, David

N1 - Funding Information: A considerable number of people have contributed to the success of this study. We are grateful to Dr Elizabeth Miller of Public Health England?s (PHE) Immunisation Division, and to the members of the British Society for Antimicrobial Chemotherapy?s Resistance Surveillance Standing Committee for helpful discussion. We are also grateful to Tony McNiff for help in data extraction and analysis and to the many PHE staff who undertook laboratory testing of these isolates, also to the NHS and Irish laboratories that have contributed isolates and data to the various surveillance programmes used here. This publication made use of the Streptococcus pneumoniae MLST website (http://pubmlst.org/spneumoniae/) sited at the University of Oxford [29]. The development of this site has been funded by the Wellcome Trust. Publisher Copyright: © 2016, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

PY - 2016/12/15

Y1 - 2016/12/15

N2 - Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001-2014; (ii) Public Health England’s (PHE) invasive isolate surveillance from 2005-2014 and (iii) referral to PHE for resistance investigation from 2005-2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin. 15A was consistently among the 10 most prevalent serotypes from 2011 in PHE and BSAC invasive isolate/bacteraemia surveillance but never previously; 26-33% of these invasive 15A isolates had triple resistance. BSAC respiratory isolates were only serotyped in 2013/14 and 2014/15 (October to September); 15A was most prevalent serotype in both periods, comprising 9-11% of isolates, 38-48% of them with triple resistance. Serotype 15A represented 0-4% of S. pneumoniae referred to PHE for reference investigation annually until 2008 but rose to 29% (2013) and 32% (2014). Almost all multidrug- resistant 15A isolates were sequence type (ST) 63 variants, whereas susceptible 15A isolates were clonally diverse. The rise of serotype 15A suggests that pneumococcal conjugate vaccines will need ongoing adaptation.

AB - Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001-2014; (ii) Public Health England’s (PHE) invasive isolate surveillance from 2005-2014 and (iii) referral to PHE for resistance investigation from 2005-2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin. 15A was consistently among the 10 most prevalent serotypes from 2011 in PHE and BSAC invasive isolate/bacteraemia surveillance but never previously; 26-33% of these invasive 15A isolates had triple resistance. BSAC respiratory isolates were only serotyped in 2013/14 and 2014/15 (October to September); 15A was most prevalent serotype in both periods, comprising 9-11% of isolates, 38-48% of them with triple resistance. Serotype 15A represented 0-4% of S. pneumoniae referred to PHE for reference investigation annually until 2008 but rose to 29% (2013) and 32% (2014). Almost all multidrug- resistant 15A isolates were sequence type (ST) 63 variants, whereas susceptible 15A isolates were clonally diverse. The rise of serotype 15A suggests that pneumococcal conjugate vaccines will need ongoing adaptation.

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DO - 10.2807/1560-7917.ES.2016.21.50.30423

M3 - Article

C2 - 28006650

AN - SCOPUS:85007048797

SN - 1025-496X

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JO - Eurosurveillance

JF - Eurosurveillance

IS - 50

ER -

Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014

Abstract

Bibliographical note

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