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Volume 19, Number 7—July 2013

Research

Pneumococcal Serotypes before and after Introduction of Conjugate Vaccines, United States, 1999–20111

Sandra S. RichterComments to Author , Kristopher P. Heilmann, Cassie L. Dohrn, Fathollah Riahi, Daniel J. Diekema, and Gary V. Doern
Author affiliations: Cleveland Clinic, Cleveland, Ohio, USA (S.S. Richter); University of Iowa Carver College of Medicine, Iowa City, Iowa, USA (K.P. Heilmann, C.L. Dohrn, F. Riahi, D.J. Diekema, G.V. Doern)

Main Article

Table 2

Serotype distribution of Streptococcus pneumoniae isolates, United States, 1999–2011*

All age groups
Children ≤5 y of age
Before PCV7, 1999–2000 Post-PCV7, 2004–2005 Post-PCV7, 2008–2009 Post-PCV13, 2010–2011 Before PCV7, 1999–2000 Post-PCV7, 2004–2005 Post-PCV7, 2008–2009 Post-PCV13, 2010–2011
PCV7
4† 69 (4.6) 34 (2.1) 7 (0.4) 6 (0.3) 14 (3.1) 0 0 0
6B† 157 (10.4) 32 (1.9) 8 (0.4) 11 (0.6) 73 (16.3) 7 (2.1) 0 0
9V† 77 (5.1) 21 (1.3) 5 (0.3) 1 (0.1) 19 (4.2) 3 (0.9) 0 0
14† 151 (10.0) 13 (0.8) 7 (0.4) 1 (0.1) 67 (15.0) 0 1 (0.2) 0
18C† 51 (3.4) 10 (0.6) 2 (0.1) 3 (0.2) 23 (5.2) 0 0 0
19F† 181 (12.0) 116 (7.0) 61 (3.1) 47 (2.7) 69 (15.4) 26 (7.9) 15 (3.6) 7 (1.9)
23F† 135 (9.0) 40 (2.4) 5 (0.3) 3 (0.2) 45 (10.1) 8 (2.4) 2 (0.5) 0
Total
821 (54.5)
266 (16.1)
95 (4.9)
72 (4.1)

310 (70.1)
44 (13.4)
18 (4.3)
7 (1.9)
Additional serotypes in PCV13
1† 17 (1.1) 12 (0.7) 10 (0.5) 2 (0.1) 3 (0.7) 2 (0.6) 1 (0.2) 0
3† 127 (8.4) 184 (11.2) 165 (8.5) 163 (9.3) 14 (3.1) 23 (7.0) 17 (4.1) 15 (4.1)
5† 0 2 (0.1) 1 (0.1) 1 (0.1) 0 0 1 (0.2) 0
6A 87 (5.8) 78 (4.7) 26 (1.3) 7 (0.4) 35 (7.8) 19 (5.8) 5 (1.2) 1 (0.3)
7F† 21 (1.4) 29 (1.8) 113 (5.8) 86 (4.9) 2 (0.5) 2 (0.6) 14 (3.4) 4 (1.1)
19A† 33 (2.2) 239 (14.5) 434 (22.3) 350 (20.0) 12 (2.7) 83 (25.3) 153 (36.7) 125 (34.1)
Total
285 (18.9)
544 (33.0)
749 (38.5)
609 (34.8)

66 (14.9)
129 (39.3)
191 (45.8)
145 (39.5)
PCV related
6C 12 (0.8) 37 (2.3) 141 (7.3) 148 (8.5) 2 (0.5) 2 (0.6) 29 (7.0) 32 (8.7)
9N 19 (1.3) 14 (0.9) 31 (1.6) 34 (1.9) 4 (0.9) 1 (0.3) 2 (0.5) 2 (0.5)
23A 10 (0.7) 47 (2.8) 86 (4.4) 81 (4.6) 0 9 (2.7) 18 (4.3) 10 (2.7)
23B 2 (0.1) 25 (1.5) 58 (3.0) 44 (2.5) 0 4 (1.2) 14 (3.3) 11 (3.0)
Other 18 (1.2)‡ 36 (2.2)§ 22 (1.1)¶ 31 (1.8)# 5 (1.1)‡ 4 (1.2)§ 5 (1.2)¶ 1 (0.3)#
Total
61 (4.1)
159 (9.7)
338 (17.4)
338 (19.3)

11 (2.5)
20 (6.1)
68 (16.3)
56 (15.3)
Non-PCV
11A† 52 (3.5) 101 (6.1) 77 (4.0) 82 (4.7) 3 (0.7) 16 (4.9) 12 (2.9) 14 (3.8)
12F 17 (1.1) 29 (1.8) 8 (0.4) 14 (0.8) 1 (0.2) 2 (0.6) 1 (0.2) 0
15A 7 (0.5) 45 (2.7) 78 (4.0) 53 (3.0) 3 (0.7) 10 (3.0) 16 (3.8) 3 (0.8)
15B† 7 (0.5) 38 (2.3) 39 (2.0) 58 (3.3) 4 (0.9) 12 (3.7) 14 (3.4) 22 (6.0)
15C 12 (0.8) 30 (1.8) 29 (1.5) 43 (2.5) 3 (0.7) 9 (2.7) 13 (3.1) 17 (4.6)
16F 17 (1.1) 38 (2.3) 57 (2.9) 39 (2.2) 0 5 (1.5) 5 (1.2) 5 (1.4)
22F† 36 (2.4) 77 (4.7) 95 (4.9) 84 (4.8) 3 (0.7) 14 (4.3) 10 (2.4) 20 (5.4)
35B 30 (2.0) 73 (4.4) 78 (4.0) 123 (7.0) 6 (1.3) 24 (7.3) 20 (4.8) 39 (10.6)
Other
113 (7.5)**
217 (13.2)††
266 (13.7)‡‡
190 (10.9)§§

19 (4.3)**
41 (12.5)††
45 (10.8)‡‡
33 (9.0)§§
NT
48 (3.2)
30 (1.8)
37 (1.9)
45 (2.6)

13 (2.9)
2 (0.6)
4 (1.0)
6 (1.6)
Total
339 (22.5)
678 (41.2)
764 (39.3)
731 (41.8)

55 (12.4)
135 (41.1)
140 (33.6)
159 (43.3)
All 1,506 1,647 1,946 1,750 442 328 417 367

*PCV7, pneumococcal conjugate 7-valent vaccine; PCV13, pneumococcal conjugate 13-valent vaccine; NT, nontypeable; ch, children.
†Serotypes in 23-valent polysaccharide pneumococcal vaccine.
‡Other low prevalence serotypes (no. isolates): in 1999–2000, serotype 7C (2), 9A (8, 2 ch), 9L (2), 18F (2), 18B (4, 3 ch).
§In 2004–2005, serotype 6D (1), 7A (1), 7C (8), 9A (5, 1 ch), 9L (5), 18F (4), 18A (3, 1 ch), 18B (5, 1 ch), 19B (3, 1 ch), 19C (1).
¶In 2008–2009, serotype 7C (12, 5 ch), 9A (3), 9L (5), 19B (1), 19C (1).
#In 2010–2011, serotype 6D (1), 7B (1 ch), 7C (21), 9A (2), 9L (5), 19B (1).
**In 1999–2000, serotype 8 (7), 10A (14, 3 ch), 11B (1), 13 (8, 1 ch), 16A (1, 1 ch), 17F (2, 1 ch), 20 (3), 21 (4, 3 ch), 25A (9, 3 ch), 25F (1), 28F (1), 28A (4), 29 (3, 1 ch), 31 (13), 33F (5, 2 ch), 33A (7, 1 ch), 34 (4), 35F (18, 2 ch), 35C (1), 36 (1), 37 (1), 38 (2), 45 (2, 1 ch), 47 (1).
††In 2004–05, serotype 2 (1), 8 (7), 10F (1), 10A (23, 1 ch), 11D (1), 12B (2), 13 (5), 15F (2), 16A (2, 1 ch), 17F (11), 20 (7, 2 ch), 21 (6, 1 ch), 24F (1), 25A (3, 1 ch), 28F (2), 28A (2), 29 (8, 6 ch), 31 (36, 6 ch), 33F (16, 4 ch), 33A (6, 3 ch), 34 (11, 1 ch), 35F (34, 6 ch), 35A (15, 4 ch), 38 (12, 3 ch), 39 (1 ch), 40 (1), 48 (1 ch).
‡‡In 2008–2009, serotype 8 (13, 1 ch), 10F (1), 10A (28, 4 ch), 10B (1), 11D (1), 13 (3), 16A (1), 17F (28, 6 ch), 20 (14, 1 ch), 21 (20, 9 ch), 22A (1 ch), 25A (6, 1 ch), 28A (2), 29 (7, 2 ch), 31 (35, 2 ch), 32F (1), 33F (23, 2 ch), 33A (17, 3 ch), 33B (3, 1 ch), 34 (23, 4 ch), 35F (25, 6 ch), 35A (2), 35C (2, 1 ch), 37 (3), 38 (3), 42 (3, 1 ch).
§§In 2010–2011, serotype 8 (10), 10A (26, 5 ch), 13 (2), 17F (15, 3 ch), 20 (6), 21 (15, 9 ch), 24A (2, 1 ch), 28A (1), 29 (3), 31 (28, 2 ch), 33F (16, 3 ch), 33A (18, 3 ch), 34 (15, 2 ch), 35F (17, 4 ch), 38 (15), 45 (1 ch).

Main Article

1Presented in part at the 112th General Meeting of the American Society for Microbiology Annual Meeting, June 19, 2012, San Francisco, CA, USA (abstract no. 2986).

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