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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 5

Serotype distribution of pneumococcal noninvasive and invasive isolates from children ≤5 y of age, United States, 1999–2011*

Serotype Noninvasive
Invasive
Before PCV7, 1999–2000 Post-PCV7, 2004–2005 Post-PCV7, 2008–2009 Post-PCV13, 2010–2011 Pen NS, 2010–2011 Before PCV7, 1999–2000 Post-PCV7, 2004–2005 Post-PCV7, 2008–2009 Post-PCV13, 2010–2011 Pen NS, 2010–2011
PCV7
4† 4 (1.3) 0 0 0 0 10 (7.0) 0 0 0 0
6B† 46 (15.1) 5 (1.8) 0 0 0 27 (19.0) 2 (3.8) 0 0 0
9V† 14 (4.6) 1 (0.4) 0 0 0 5 (3.5) 2 (3.8) 0 0 0
14† 28 (9.2) 0 1 (0.3) 0 0 39 (27.5) 0 0 0 0
18C† 7 (2.3) 0 0 0 0 16 (11.3) 0 0 0 0
19F† 53 (17.4) 19 (6.9) 14 (3.8) 7 (2.2) 6 (3.2) 16 (11.3) 7 (13.2) 1 (2.0) 0 0
23F† 37 (12.1) 8 (2.9) 2 (0.5) 0 0 8 (5.6) 0 0 0 0
Total
189 (63.0)
33 (12.0)
17 (4.6)
7 (2.2)
6 (3.2)

121 (85.2)
11 (20.8)
1 (2.0)
0
0
Additional serotypes in PCV13
1† 2 (0.7) 1 (0.4) 0 0 0 1 (0.7) 1 (1.9) 1 (2.0) 0 0
3† 14 (4.6) 22 (8.0) 14 (3.8) 13 (4.0) 0 0 1 (1.9) 3 (6.1) 2 (4.9) 0
5† 0 0 0 0 0 0 0 1 (2.0) 0 0
6A 24 (7.9) 16 (5.8) 5 (1.4) 1 (0.3) 1 (0.5) 11 (7.8) 3 (5.7) 0 0 0
7F† 1 (0.3) 2 (0.7) 6 (1.6) 2 (0.6) 0 1 (0.7) 0 8 (16.3) 2 (4.9) 0
19A† 11 (3.6) 68 (24.7) 135 (36.7) 107 (32.8) 94 (50.3) 1 (0.7) 15 (28.3) 18 (36.7) 18 (43.9) 13 (59.1)
Total
52 (17.3)
109 (39.6)
160 (43.5)
123 (37.7)
95 (50.8)

14 (9.9)
20 (37.7)
31 (63.3)
22 (53.7)
13 (59.1)
PCV-related
6C 2 (0.7) 2 (0.7) 28 (7.6) 29 (8.9) 21 (11.2) 0 0 1 (2.0) 3 (7.3) 2 (9.1)
9N 4 (1.3) 1 (0.4) 2 (0.5) 2 (0.6) 0 0 0 0 0 0
23A 0 8 (2.9) 17 (4.6) 10 (3.1) 5 (2.7) 0 1 (1.9) 1 (2.0) 0 0
23B 0 4 (1.5) 14 (3.8) 9 (2.8) 1 (0.5) 0 0 0 2 (4.9) 2 (9.1)
Other 4 (1.3)‡ 3 (1.1)§ 5 (1.4)¶ 1 (0.3)# 0 1 (0.7)‡ 1 (1.9)§ 0 0 0
Total
10 (3.3)
18 (6.5)
66 (17.9)
51 (15.6)
27 (14.4)

1 (0.7)
2 (3.8)
2 (4.1)
5 (12.2)
4 (18.2)
Non-PCV
11A† 3 (1.0) 15 (5.5) 12 (3.3) 14 (4.3) 4 (2.1) 0 1 (1.9) 0 0 0
15A 3 (1.0) 9 (3.3) 13 (3.5) 2 (0.6) 0 0 1 (1.9) 3 (6.1) 1 (2.4) 1 (4.5)
15B† 3 (1.0) 10 (3.6) 14 (3.8) 20 (6.1) 11 (5.9) 1 (0.7) 2 (3.8) 0 2 (4.9) 0
15C 2 (0.7) 7 (2.6) 11 (3.0) 14 (4.3) 7 (3.7) 1 (0.7) 2 (3.8) 2 (4.1) 3 (7.3) 1 (4.5)
21 3 (1.0) 1 (0.4) 9 (2.5) 9 (2.8) 2 (1.1) 0 0 0 0 0
22F† 2 (0.7) 12 (4.4) 7 (1.9) 18 (5.5) 0 1 (0.7) 2 (3.8) 3 (6.1) 2 (4.9) 0
35B
6 (2.0)
23 (8.4)
20 (5.4)
36 (11.0)
35 (18.7)

0
1 (1.9)
0
3 (7.3)
3 (13.6)
Other
15 (5.0)**
36 (13.1)††
35 (9.5)‡‡
26 (8.0)§§
0

2 (1.4)**
11 (20.8)††
7 (14.3)‡‡
3 (7.3)§§
0
NT
12 (3.9)
2 (0.7)
4 (1.1)
6 (1.8)
0

1 (0.7)
0
0
0
0
Total
49 (16.3)
115 (41.8)
125 (34.0)
145 (44.5)
59 (31.6)

6 (4.2)
20 (37.7)
15 (30.6)
14 (34.1)
5 (22.7)
All
300
275
368
326
187

142
53
49
41
22
% Pen NS 50.2 48.0 59.2 57.4 NA 26.1 43.4 40.8 53.7 NA

*Values are no. (%) isolates unless otherwise indicate. PCV7, pneumococcal conjugate 7-valent vaccine; PCV13, pneumococcal conjugate 13-valent vaccine; Pen NS, penicillin nonsusceptible (MIC ≥0.12 µg/mL); NT, nontypeable; NA, not applicable; non, noninvasive; inv, invasive.
†Serotypes in 23-valent polysaccharide pneumococcal vaccine.
‡Other low prevalence serotypes (no. isolates): in 1999–00, serotype 9A (1 non; 1 inv), 18B (3 non).
§In 2004–2005, serotype 9A (1 non), 18A (1 non), 18B (1 non), 19B (1 inv).
¶In 2008–2009, serotype 7C (5 non).
#In 2010–11, serotype 7B (1 non).
**In 1999–2000, serotype 10A (3 non), 12F (1 inv), 13 (1 non), 16A (1 non), 17F (1non), 25A (2 non, 1 inv), 29 (1 non), 33F (2 non), 33A (1 non), 35F (2 non), 45 (1 non).
††In 2004–2005, serotype 10A (1 non), 12F (1 non, 1 inv), 16F (3 non, 2 inv), 16A (1 non), 20 (1 non, 1 inv), 25A (1 inv), 29 (6 non), 31 (5 non, 1 inv), 33F (4 non), 33A (1 non, 2 inv), 34 (1 non), 35F (5 non, 1 inv), 35A (4 non), 38 (1 non, 2 inv), 39 (1 non), 48 (1 non).
‡‡In 2008–2009, serotype 8 (1 non), 10A (4 non), 12F (1 inv), 16F (5 non), 17F (4 non, 2 inv), 20 (1 non), 22A (1 non), 25A (1 non), 29 (1 non, 1 inv), 31 (2 non), 33F (2 non), 33A (2 non, 1 inv), 33B (1 non), 34 (3 non, 1 inv), 35F (5 non, 1 inv), 35C (1 non), 42 (1 non).
§§In 2010–2011, serotype 10A (5 non), 16F (5 non), 17F (3 non), 24A (1 non), 31 (2 non), 33F (2 non, 1 inv), 33A (1 non, 2 inv), 34 (2 non), 35F (4 non), 45 (1 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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