Abstract
.Childhood vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in Cambodia in January 2015. Baseline data regarding circulating serotypes are scarce. All microbiology laboratories in Cambodia were contacted for identification of stored isolates of Streptococcus pneumoniae from clinical specimens taken before the introduction of PCV13. Available isolates were serotyped using a multiplex polymerase chain reaction method. Among 166 identified isolates available for serotyping from patients with pneumococcal disease, 4% were isolated from upper respiratory samples and 80% were from lower respiratory samples, and 16% were invasive isolates. PCV13 serotypes accounted for 60% (95% confidence interval [CI] 52–67) of all isolates; 56% (95% CI 48–64) of noninvasive and 77% (95% CI 57–89) of invasive isolates. Antibiotic resistance was more common among PCV13 serotypes. This study of clinical S. pneumoniae isolates supports the potential for high reduction in pneumococcal disease burden and may serve as baseline data for future monitoring of S. pneumoniae serotypes circulation after implementation of PCV13 childhood vaccination in Cambodia.
Highlights
Streptococcus pneumoniae cause a wide spectrum of infections, ranging from invasive disease with a high case-fatality rate to asymptomatic colonization
All principal microbiological laboratories in Cambodia were contacted for identification of stored isolates of S. pneumoniae from specimens taken before January 2015
A second study from the same center based on invasive isolates (N = 50) 2008–2012 predicted 92% PCV13 coverage.[11]
Summary
Streptococcus pneumoniae (pneumococci) cause a wide spectrum of infections, ranging from invasive disease with a high case-fatality rate to asymptomatic colonization. Pneumococci can be divided into more than 90 different serotypes, based on differences in their capsular polysaccharides, with varying ability to cause severe disease.[2,3] The distribution of serotypes varies with age and geographical area, whereas the potential coverage rates of vaccines may differ by target population.[4,5] In high-income countries, the incidence of invasive pneumococcal disease by included vaccine types has declined significantly with the introduction of the pneumococcal conjugated vaccine (PCV).[6,7] Data from low-income countries are less robust.[8]
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