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Background <p>The ongoing burden of mortality and morbidity associated with <i>Streptococcus pneumoniae</i> infections requires that monitoring of carriage epidemiology continues. Here, we present data from the annual, cross-sectional surveillance study in Southampton UK on serotype epidemiology and diversity, as well as carriage of other frequent colonisers of the respiratory tract in over 7000 children over a period of seventeen years (2006–2023).</p> Methods <p>Children were recruited from two sites: Site 1 - Southampton General Hospital, administered by University Hospital Southampton (UHS) NHS Foundation Trust and Site 2– a collection of community health care facilities within the Solent NHS Trust region. Recruitment was limited to children &lt; 5-years-old. Pneumococcal serotyping was done using whole genome sequence data.</p> Results <p>A total of 7,686 swabs were collected from which 2,386 (31%) pneumococci were recovered. Carriage of pneumococci has remained consistent (median carriage prevalence 31.4%) even with the almost complete removal of vaccine-type (VT) serotypes. Examining three PCV13 periods separately (pre, early and late), carriage was not significantly different at 27.7%, 35.3% and 39.3% respectively. A decrease in carriage of <i>Haemophilus influenzae</i>, <i>Staphylococcus aureus</i> and <i>Moraxella catarrhalis</i> was seen pre-PCV13 (following PCV7 implementation) but has since stabilised. Continued, low-level persistence of VTs 3, 19A and 19F was noted. PCV13 did not impact the pneumococcal serotype rank abundance despite clear reductions in targeted serotypes and fluctuations in other non-VT serotypes such as 15A, 23B and 23B1. Non-PCV13 PCV20 serotypes 10A and 11A, in addition to paired prevalence of 15B and 15C (15B/C) were in the five most isolated serotypes in the late-PCV13 period (2012 to present). Non-PCV13 PCV20 serotypes now account for approximately 40% of all carriage. By contrast, the serotypes only included in PCV15 (22F and 33F) represented just 7% in the same period.</p> Conclusion <p>With consistent carriage prevalence in this UK paediatric population since PCV13 introduction, serotype epidemiology is now dominated by non-PCV13 serotypes that are in higher valency vaccines.</p>

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Changes in carriage and serotype diversity of Streptococcus pneumoniae and other respiratory pathobionts in the UK between pre-PCV13 (2006-10), early-PCV13 (2010-12) and late-PCV13 (2012-23) periods

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  • 发表日期：

    2025年9月5日

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  • David W. Cleary,
  • Rebecca Anderson,
  • Jessica Jones,
  • Rebecca A. Gladstone,
  • Karen L. Osman,
  • Vanessa T. Devine,
  • Denise E. Morris,
  • Alex J. J. Lister,
  • Stephen Gomer,
  • Rebecca E. Hocknell,
  • Emily J. Dineen,
  • Johanna M. Jefferies,
  • James Campling,
  • Maria Lahuerta,
  • Kyla Hayford,
  • Jo Southern,
  • Bradford D. Gessner,
  • Stephanie W. Lo,
  • Stephen D. Bentley,
  • Saul N. Faust,
  • Stuart C. Clarke

摘要

Background

The ongoing burden of mortality and morbidity associated with Streptococcus pneumoniae infections requires that monitoring of carriage epidemiology continues. Here, we present data from the annual, cross-sectional surveillance study in Southampton UK on serotype epidemiology and diversity, as well as carriage of other frequent colonisers of the respiratory tract in over 7000 children over a period of seventeen years (2006–2023).

Methods

Children were recruited from two sites: Site 1 - Southampton General Hospital, administered by University Hospital Southampton (UHS) NHS Foundation Trust and Site 2– a collection of community health care facilities within the Solent NHS Trust region. Recruitment was limited to children < 5-years-old. Pneumococcal serotyping was done using whole genome sequence data.

Results

A total of 7,686 swabs were collected from which 2,386 (31%) pneumococci were recovered. Carriage of pneumococci has remained consistent (median carriage prevalence 31.4%) even with the almost complete removal of vaccine-type (VT) serotypes. Examining three PCV13 periods separately (pre, early and late), carriage was not significantly different at 27.7%, 35.3% and 39.3% respectively. A decrease in carriage of Haemophilus influenzae, Staphylococcus aureus and Moraxella catarrhalis was seen pre-PCV13 (following PCV7 implementation) but has since stabilised. Continued, low-level persistence of VTs 3, 19A and 19F was noted. PCV13 did not impact the pneumococcal serotype rank abundance despite clear reductions in targeted serotypes and fluctuations in other non-VT serotypes such as 15A, 23B and 23B1. Non-PCV13 PCV20 serotypes 10A and 11A, in addition to paired prevalence of 15B and 15C (15B/C) were in the five most isolated serotypes in the late-PCV13 period (2012 to present). Non-PCV13 PCV20 serotypes now account for approximately 40% of all carriage. By contrast, the serotypes only included in PCV15 (22F and 33F) represented just 7% in the same period.

Conclusion

With consistent carriage prevalence in this UK paediatric population since PCV13 introduction, serotype epidemiology is now dominated by non-PCV13 serotypes that are in higher valency vaccines.