Ayman M. Abdelhamed, United States of America

Case Western Reserve University and University Hospitals Cleveland Medical Center Pathology

Author Of 3 Presentations

CHANGES IN STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTIONS 1999-2019 AT A NORTHEAST OHIO ACADEMIC MEDICAL CENTER FOLLOWING INTRODUCTION OF 7- AND 13-VALENT CONJUGATE PNEUMOCOCCAL VACCINES (ID 701)

Abstract

Background

23-valent polysaccharide (P23, Pneumovax, Merck) and 7- and 13-valent conjugated vaccines (PCV7, PCV13, Prevnar, Pfizer) are in clinical use, with 15-valent (PCV15, V114, Merck), and 20-valent (PCV20, PF-06482077, Pfizer) conjugated vaccines under development.

Methods

This study compares vaccine coverage of serotypes of pneumococcal isolates from all sources from the year prior to PCV7 introduction (1999), the period following use of PCV7 (2000-2009), the year of PCV13 introduction (2010), and the period since introduction of PCV13 (2011-2019).

Results

2,336 S. pneumoniae were isolated, 196 in 1999, 1,369 in 2000-2009, 68 in 2010 and 708 in 2011-2019 (Table). PCV7 serotypes decreased from 68.8% in 1999 to <12.4% after 2003. Twenty-eight isolates with serotypes included in PCV7 were recovered 2015-2019, with 25 (89%) serotype 19F. The 6 serotypes added to PCV13 accounted for <20% of isolates 1999-2003, increasing to around 45% 2004-2009, and decreasing to <20% thereafter, with types 3 (50/76) and 19A (23/76) predominating. Serotypes included in PVC15, PCV20 and P23 improved coverage of types in PCV13 by 4.6%, 13.9% and 18.9%, respectively, during 2017-2019.

vaccine abstr table.png

Conclusions

The proportion of PCV7 and PCV13 serotypes decreased considerably after their introduction. P23 and the two conjugated vaccines in development increase coverage of serotypes not in PCV13.

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CHANGES IN ANTIMICROBIAL SUSCEPTIBILITY OF STREPTOCOCCUS PNEUMONIAE 1999-2019 AT A NORTHEAST OHIO ACADEMIC MEDICAL CENTER FOLLOWING INTRODUCTION OF 7- AND 13-VALENT CONJUGATE PNEUMOCOCCAL VACCINES (ID 1048)

Abstract

Background

Antimicrobial resistance has presented a major clinical challenge, with many resistant serotypes included in 7- and 13-valent conjugated vaccines (PCV7, PCV13, Prevnar, Pfizer) introduced in 200 and 2010, respectively.

Methods

This study compares antimicrobial susceptibility of key antimicrobials against pneumococcal isolates from all sources from the year prior to PCV7 introduction (1999), the period following use of PCV7 (2000-2009), the year of PCV13 introduction (2010), and the period since introduction of PCV13 (2011-2019).

Results

2,336 S. pneumoniae were isolated, 196 in 1999, 1,369 in 2000-2009, 68 in 2010 and 708 in 2011-2019 (Table). Over the study period, susceptibility increased for penicillin IV (52.0% to 66.2% at meningitis and 81.6% to 93.1% at nonmeningitis breakpoints), amoxicillin (71.9% to 93.5%), ceftriaxone IV (72.4% to 87.5% at meningitis and 93.9% to 98.1% at nonmeningitis breakpoints) and trimethoprim-sulfamethoxazole (54.6% to 79.6%), and decreased for clindamycin (94.9% to 86.1%). Azithromycin susceptibility initially decreased from 69.4% in 1999 to 47.9% in 2010, and then increased to 60.2% in 2017-2019. Levofloxacin susceptibility was high throughout.

susc abstr table.png

Conclusions

Antimicrobial susceptibility of pneumococci to penicillin, amoxicillin, ceftriaxone and trimethoprim-sulfamethoxazole improved after introduction of conjugate vaccines, while susceptibility to azithromycin and clindamycin did not, with almost 40% of isolates resistant to azithromycin in 2017-2019.

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