Abstract
The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. The most common serotypes causing IPD were 8 and 19A. In patients <15 years of age, serotypes associated with increased CFR in IPD, compared with serotype 8 and controlling for confounding factors, were 11A, 13, 19F, 15A, and 6A. None of these serotypes were associated with increased CFR in meningitis. Among IPD patients >15 years of age, serotype 15B/C was associated with increased CFR. Among meningitis patients of all ages, serotype 1 was associated with increased CFR. PCV13 serotypes 1, 3, 6A, 19A, and 19F should be monitored, and serotypes 8, 12F, 15A, and 15B/C should be considered for inclusion in vaccines to reduce deaths caused by S. pneumoniae.
Highlights
The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity
Of the distinguishable serotype cases, 4,272 (91.8%) cases had serotypes included in the pneumococcal conjugate vaccines (PCVs)-13 vaccine or serotypes that comprised >1% of all cases
Nine years after PCV7 introduction and 5 years after PCV13 introduction in South Africa, the non-PCV13 serotype 8 is the most common serotype found in invasive pneumococcal disease (IPD) patients followed by 19A, 12F, and 3
Summary
The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. In patients 15 years of age were 1, 19A, 4, and 3; serotypes 1 and 19F were associated with death [9]. We aimed to determine which serotypes are associated with increased CFR in IPD and meningitis patients in the vaccine era in South Africa. Our aims were to identify possible differences of serotypes associated with death in children and adults and between total
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