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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 4

Serotype distribution of pencillin-nonsusceptible noninvasive and invasive pneumococcal isolates, United States, 1999–2011*

Serotype No. (%) isolates
Noninvasive
Invasive
Pencillin intermediate and resistant (oral breakpoint), MIC ≥0.12 µg/mL
Pencillin resistant (meningitis breakpoint), MIC ≥0.12 µg/mL
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† 1 (0.3) 2 (0.5) 0 0 1 (0.8) 0 0 0
6B† 63 (16.8) 15 (3.6) 3 (0.5) 4 (0.7) 24 (18.9) 5 (4.3) 2 (1.7) 1 (0.8)
9V† 44 (11.8) 11 (2.6) 5 (0.8) 0 23 (18.1) 7 (6.0) 0 0
14† 38 (10.2) 6 (1.4) 3 (0.5) 0 33 (26.0) 3 (2.6) 1 (0.8) 0
18C† 2 (0.5) 0 0 1 (0.8) 0 0 0
19F† 85 (22.7) 56 (13.4) 38 (6.2) 27 (4.8) 10 (7.9) 12 (10.3) 2 (1.7) 1 (0.8)
23F† 58 (15.5) 16 (3.8) 3 (0.5) 3 (0.5) 13 (10.2) 3 (2.6) 1 (0.8) 0
Total
291 (77.8)
106 (25.4)
52 (8.5)
34 (6.1)

105 (82.7)
30 (25.6)
6 (5.0)
2 (1.6)
Additional serotypes in PCV13
1† 0 1 (0.2) 0 0 0 0 0 0
3† 2 (0.5) 5 (1.2) 0 2 (0.4) 0 1 (0.9) 0 0
6A 17 (4.5) 32 (7.7) 17 (2.3) 3 (0.5) 6 (4.7) 17 (14.5) 2 (1.7) 1 (0.8)
7F† 0 6 (1.4) 0 1 (0.2) 0 0 1 (0.8) 1 (0.8)
19A† 16 (4.3) 111 (26.6) 275 (44.8) 227 (40.6) 7 (5.5) 44 (37.6) 59 (49.6) 55 (44.0)
Total
35 (9.4)
149 (35.6)
292 (47.6)
233 (41.7)

13 (10.2)
62 (53.0)
62 (52.1)
57 (45.6)
PCV-related
6C 3 (0.8) 12 (2.9) 61 (9.9) 63 (11.3) 1 (0.8) 2 (1.7) 13 (10.9) 14 (11.2)
9A 2 (0.5) 4 (1.0) 2 (0.3) 1 (0.2) 4 (3.2) 0 1 (0.8) 1 (0.8)
19B 0 0 0 1 (0.2) 0 1 (0.9) 1 (0.8) 0
23A 2 (0.5) 13 (3.1) 39 (6.4) 37 (6.6) 0 4 (3.4) 13 (10.9) 19 (15.2)
23B 0 5 (1.2) 12 (2.0) 7 (1.3) 0 0 1 (0.8) 6 (4.8)
Other 2 (0.5)‡ 2 (0.5)§ 1 (0.2)¶ 2 (0.4)# 0 0 0 0
Total
9 (2.4)
36 (8.6)
115 (18.7)
111 (19.9)

5 (3.9)
7 (6.0)
29 (24.4)
40 (32.0)
Non-PCV
11A† 0 5 (1.2) 2 (0.3) 7 (1.3) 0 1 (0.9) 0 0
15A 3 (0.8) 27 (6.5) 56 (9.1) 29 (5.1) 0 8 (6.8) 9 (7.6) 11 (8.8)
15B† 0 1 (0.2) 6 (1.0) 22 (3.9) 0 0 1 (0.8) 0
15C 0 3 (0.7) 7 (1.1) 12 (2.1) 0 0 3 (2.5) 1 (0.8)
35B 19 (5.1) 56 (13.4) 56 (9.1) 89 (15.9) 1 (0.8) 5 (4.3) 7 (5.9) 13 (10.4)
Other
4 (1.1)**
26(6.2)††
19 (3.1)‡‡
11 (2.0)§§

1 (0.8)**
2 (1.7)††
2 (1.7)‡‡
0
NT
13 (3.5)
9 (2.2)
9 (1.4)
11 (2.0)

2 (1.6)
2 (1.7)
0
1 (0.8)
Total
39 (10.4)
127 (30.4)
155 (25.2)
181 (32.4)

4 (3.1)
18 (15.4)
22 (18.5)
26 (20.8)
All serotypes 374 418 614 559 127 117 119 125

*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 9N (1 non), 18 F (1 non).
§In 2004–2005, serotype 18B (1 non), 19C (1 non).
¶In 2008–2009, serotype 9N (1 non).
#In 2010–2011, serotype 7C (1 non), 9N (1 non).
**In 1999–00, serotype 16F (2 non), 22F (1 non), 29 (1 non, 1 inv).
††In 2004–2005, serotype 15F (1 non), 16F (1 non), 20 (1 non), 21 (1 non), 22F (1 inv), 29 (8 non), 31 (1 non), 33F (1 inv), 35A (9 non), 35F (2 non), 39 (1 non), 48 (1 non).
‡‡In 2008–09, serotype 8 (1 non), 11D (1 non), 17F (2 non), 21 (1 non), 22F (1 inv), 22A (1 non), 25A (1 non), 29 (6 non, 1 inv), 33F (1 non), 34 (1 non), 35A (1 non), 42 (3 non).
§§In 2010–11, serotype 16F (2 non), 21 (2 non), 29 (1 non), 31 (2 non), 33F (1 non), 34 (1 non), 38 (2 non).

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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