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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 3

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

Serotype No. (%) isolates
Noninvasive
Invasive
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† 20 (1.9) 11 (0.9) 5 (0.4) 2 (0.2) 49 (10.2) 23 (5.3) 2 (0.4) 4 (0.9)
6B† 104 (10.1) 25 (2.1) 5 (0.4) 7 (0.5) 53 (11.0) 7 (1.6) 3 (0.6) 4 (0.9)
9V† 47 (4.6) 12 (1.0) 5 (0.4) 0 30 (6.3) 9 (2.1) 0 1 (0.2)
14† 69 (6.7) 9 (0.7) 5 (0.4) 0 82 (17.1) 4 (0.9) 2 (0.4) 1 (0.2)
18C† 25 (2.4) 6 (0.5) 0 2 (0.2) 26 (5.4) 4 (0.9) 2 (0.4) 1 (0.2)
19F† 144 (14.0) 95 (7.8) 55 (3.8) 41 (3.1) 37 (7.7) 21 (4.8) 6 (1.2) 6 (1.4)
23F† 105 (10.2) 33 (2.7) 4 (0.3) 3 (0.2) 30 (6.3) 7 (1.6) 1 (0.2) 0
Total 514 (50.1) 191 (15.8) 79 (5.5) 55 (4.2) 307 (64.0) 75 (17.2) 16 (3.2) 17 (3.8)
Additional serotypes in PCV13
1† 9 (0.9) 6 (0.5) 4 (0.3) 0 8 (1.7) 6 (1.4) 6 (1.2) 2 (0.5)
3† 108 (10.5) 145 (12.0) 126 (8.7) 121 (9.3) 19 (4.0) 39 (8.9) 39 (7.7) 42 (9.5)
5† 0 2 (0.2) 0 1 (0.1) 0 0 1 (0.2) 0
6A 56 (5.5) 53 (4.4) 21 (1.5) 4 (0.3) 31 (6.5) 25 (5.7) 5 (1.0) 3 (0.7)
7F† 10 (1.0) 11 (0.9) 38 (2.6) 31 (2.4) 11 (2.3) 18 (4.1) 75 (14.9) 55 (12.4)
19A† 24 (2.3) 163 (13.5) 330 (22.9) 269 (20.6) 9 (1.9) 76 (17.4) 104 (20.6) 81 (18.2)
Total 207 (20.2) 380 (31.4) 519 (36.0) 426 (32.6) 78 (16.3) 164 (37.6) 230 (45.6) 183 (41.2)
PCV related
6C 10 (1.0) 30 (2.5) 104 (7.2) 113 (8.7) 2 (0.4) 7 (1.6) 37 (7.3) 35 (7.9)
9N 14 (1.4) 12 (1.0) 22 (1.5) 20 (1.5) 5 (1.3) 2 (0.5) 9 (1.8) 14 (3.2)
23A 10 (1.0) 37 (3.1) 65 (4.5) 58 (4.4) 0 10 (2.3) 21 (4.2) 23 (5.2)
23B 2 (0.2) 22 (1.8) 50 (3.5) 36 (2.8) 0 3 (0.7) 8 (1.6) 8 (1.8)
Other 12 (1.2)‡ 26 (2.1)§ 13 (0.9)¶ 23 (1.8)# 6 (2.3)‡ 10 (2.3)§ 9 (1.8)¶ 8 (1.8)#
Total 48 (4.7) 127 (10.5) 254 (17.6) 250 (19.1) 13 (2.7) 32 (7.3) 84 (16.7) 88 (19.8)
Non-PCV
11A† 39 (3.8) 89 (7.4) 64 (4.4) 71 (5.4) 13 (2.7) 12 (2.8) 13 (2.6) 11 (2.5)
12F 4 (0.4) 4 (0.3) 3 (0.2) 13 (2.7) 25 (5.7) 8 (1.6) 11 (2.5)
15A 6 (0.6) 35 (2.9) 67 (4.7) 36 (2.8) 1 (0.2) 10 (2.3) 11 (2.2) 17 (3.8)
15B† 5 (0.5) 27 (2.2) 35 (2.4) 52 (4.0) 2 (0.4) 11 (2.5) 4 (0.8) 6 (1.4)
15C 9 (0.9) 21 (1.7) 24 (1.7) 36 (2.8) 3 (0.6) 9 (2.1) 5 (1.0) 7 (1.6)
16F 11 (1.1) 27 (2.2) 44 (3.1) 31 (2.4) 6 (1.3) 11 (2.5) 13 (2.6) 8 (1.8)
22F† 19 (1.9) 50 (4.1) 53 (3.7) 56 (4.3) 17 (3.5) 27 (6.2) 42 (8.3) 28 (6.3)
35B 28 (2.7) 68 (5.6) 70 (4.9) 104 (8.0) 2 (0.4) 5 (1.2) 8 (1.6) 19 (4.3)
Other 94 (9.2)** 165 (13.6)†† 198 (13.7)‡‡ 144 (11.0)§§ 19 (4.0)** 52 (11.9)†† 68 (13.5)‡‡ 46 (10.4)§§
NT 42 (4.1) 27 (2.2) 53 (2.4) 42 (3.2) 6 (1.3) 3 (0.7) 2 (0.4) 3 (0.7)
Total 257 (25.0) 513 (42.4) 590 (40.9) 575 (44.0) 82 (17.1) 165 (37.8) 174 (34.5) 156 (35.1)
All 1,026 1,211 1,442 1,306 480 436 504 444

*PCV7, pneumococcal conjugate 7-valent vaccine; PCV13, pneumococcal conjugate 13-valent vaccine; NT, nontypeable; non, noninvasive; inv, invasive.
†Serotypes in 23-valent polysaccharide pneumococcal vaccine.
‡Other low prevalence serotypes (no. isolates): in 1999–2000, serotype 7C (2 non), 9A (4 non; 4 inv), 9L (2 non), 18F (1 non; 1 inv), 18B (3 non; 1 inv).
§In 2004–2005, serotype 6D (1 non), 7A (1 non), 7C (5 non; 3 inv), 9A (4 non; 1 inv), 9L (4 non; 1 inv), 18F (2 non; 2 inv), 18A (3 non), 18B (5 non), 19B (3 inv), 19C (1 non).
¶In 2008–2009, serotype 7C (9 non; 3 inv), 9A (2 non; 1 inv), 9L (1 non; 4 inv), 19B (1 inv), 19C (1 non).
#In 2010–2011, serotype 6D (1 non), 7B (1 non), 7C (15 non; 6 inv), 9A (1 non; 1 inv), 9L (4 non; 1 inv), 19B (1 non).
**In 1999–2000, serotype 8 (3 non; 4 inv); 10A (13 non, 1 inv); 11B (1 non); 13 (8 non); 16A (1 non); 17F (2 non); 20 (2 non; 1 inv); 21 (3 non; 1 inv); 25A (7 non; 2 inv); 25F ( 1 non); 28F (1 non); 28A (3 non; 1 inv); 29 (1 non; 2 inv); 31 (12 non; 1 inv); 33F (4 non; 1 inv); 33A (6 non; 1 inv); 34 (4 non); 35F (15 non; 3 inv); 35C (1 inv); 36 (1 non); 37 (1 non); 38 (2 non); 45 (2 non); 47 (1 non).
††In 2004–2005, serotype 2 (1 non), 8 (3 non; 4 inv), 10F (1 inv), 10A (17 non; 6 inv), 11D (1 non), 12B (1 non; 1 inv), 13 (3 non; 2 inv), 15F (1 non; 1 inv), 16A (2 non), 17F (7 non; 4 inv), 20 (4 non; 3 inv), 21 (6 non), 24F (1 non), 25A (2 non; 1 inv), 28F (2 inv), 28A (1 non; 1 inv), 29 (8 non), 31 (32 non; 4 inv), 33F (10 non; 6 inv), 33A (2 non; 4 inv), 34 (9 non; 2 inv), 35F (28 non; 6 inv), 35A (15 non), 38 (8 non; 4 inv), 39 (1 non), 40 (1 non), 48 (1 non).
‡‡In 2008–2009, serotype 8 (6 non; 7 inv), 10F (1 inv), 10A (23 non; 5 inv), 10B (1 inv), 11D (1 non), 13 (2 non; 1 inv), 16A (1 inv), 17F (24 non; 4 inv), 20 (7 non; 7 inv), 21 (19 non; 1 inv), 22A (1 non), 25A (5 non; 1 inv), 28A (2 non), 29 (6 non; 1 inv), 31 (27 non; 8 inv), 32F (1 inv), 33F (11 non; 12 inv), 33A (11 non; 6 inv), 33B (3 non), 34 (18 non; 5 inv), 35F (21 non; 4 inv), 35A (2 non), 35C (2 non), 37 (3 non), 38 (1 non; 2 inv), 42 (3 non).
§§In 2010–2011, serotype 8 (4 non; 6 inv), 10A (21 non; 5 inv), 13 (2 non), 17F (13 non; 2 inv), 20 (3 non; 3 inv), 21 (14 non; 1 inv), 24A (2 non), 28A (1 non), 29 (3 non), 31 (24 non; 4 inv), 33F (10 non; 6 inv), 33A (9 non; 9 inv), 34 (10 non; 5 inv), 35F (15 non; 2 inv), 38 (12 non; 3 inv), 45 (1 non).

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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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