Anne Von Gottberg, South Africa
Author Of 5 Presentations
PNEUMOCOCCAL SEROTYPES ASSOCIATED WITH MORTALITY IN PERSONS AGED 5 YEARS AND ABOVE IN SOUTH AFRICA DURING THE POST-VACCINATION ERA (ID 328)
Abstract
Background
Pneumococcal serotypes 19F and 1 were associated with mortality amongst adults and adolescents in the pre-vaccine era in South Africa (SA). We assessed the association of serotype with mortality in individuals aged ≥5 years with invasive pneumococcal disease (IPD) during the vaccine era.
Methods
We conducted surveillance for laboratory-confirmed IPD at 28 hospitals in SA during 2012-2018. We used multivariable logistic regression to compare the association of serotype with in-hospital outcome.
Results
Of 3453 IPD cases with available serotype, age and outcome information, 1158 (34%) died (47% (458/970) with meningitis, 29% (643/2219) with bacteremia and 22% (57/264) with other invasive disease). Overall among IPD, compared to patients infected with serotype 8 (the most common serotype identified) and after adjusting for age, HIV status and specimen type, those with serotype 15B/C (OR:2.01, 95%CI: 1.16-3.48) were more likely to die. When restricting to meningitis cases, patients with serotype 23A (OR:0.31, 95%CI:0.10-0.95) were less likely to die compared to patients with serotype 8.
Conclusions
In the post-vaccine era, in ages ≥5 years, serotype 15B/C is associated with increased mortality, however this serotype is not included in the currently available conjugate vaccines.
EMERGENCE OF A COTRIMOXAZOLE RESISTANT SEROTYPE 16F LINEAGE IN AN INTENSIVELY VACCINATED AFRICAN BIRTH COHORT: THE DRAKENSTEIN CHILD HEALTH STUDY (ID 930)
- Felix Dube, South Africa
- Stephanie Lo, United Kingdom
- Chrispin Chaguza, United Kingdom
- Gillian Ndhlovu, South Africa
- Regina Esinam Abotsi, South Africa
- Rethabile Mokupi,
- Wendy S. Blose, South Africa
- Anne Von Gottberg, South Africa
- Lesley McGee, United States of America
- Ekaterina A. Brzhozovskaya, Russian Federation
- Alexander Davydov,
- Leonid Titov,
- Rebecca Ford, Papua New Guinea
- Ron Dagan, Israel
- Keith P. Klugman, United States of America
- Heather Zar,
- Stephen D. Bentley, United Kingdom
- Mark Nicol, South Africa
IMPACT OF THE PNEUMOCOCCAL CONJUGATE VACCINE ON PNEUMONIA MORTALITY IN SOUTH AFRICA, 1999-2016: A RETROSPECTIVE OBSERVATIONAL STUDY (ID 118)
PNEUMOCOCCAL SEROTYPES ASSOCIATED WITH MORTALITY AMONG CHILDREN LESS THAN 5 YEARS IN SOUTH AFRICA IN THE POST-VACCINATION ERA (ID 163)
Abstract
Background
Mortality due to S. pneumoniae is particularly high amongst children. We assessed the association of serotype with mortality in ages below 5 years in invasive pneumococcal disease (IPD) in the post-vaccine era in South Africa (SA).
Methods
We conducted surveillance for laboratory-confirmed IPD at 28 hospitals in SA during 2012-2018. We used multivariable logistic regression to compare the association of serotype with in-hospital outcome.
Results
Of 825 IPD cases with pneumococcal serotype, age and outcome data, 212(26%) died (31%(79/254) with meningitis, 21% (109/513) with bacteremia and 41%(24/58) from other invasive disease). Overall among IPD, compared to patients infected with serotype 8 (the most common serotype identified) and after adjusting for age, HIV status and specimen type, those with serotypes 15A (OR:5.0, 95%CI:2.0-12.1), 6A (OR:4.8, 95%CI:1.8-12.9), 19F (OR:3.3, 95%CI:1.3-8.6), 22F (OR:6.8, 95%CI:1.5-31.7), 17F (OR:3.8, 95%CI:1.2-12.2), 11A (OR:6.0, 95%CI:1.2-28.7), 13 (OR:4.1, 95%CI:1.2-14.7) and 35B (OR:2.6, 95%CI:1.1-6.2) were more likely to die. In meningitis cases, those with serotype 6A (OR:13.1, 95%CI:1.2-139.5) were more likely to die compared to serotype 8.
Conclusions
In the vaccine era in children aged <5 years, of the serotypes associated with increased mortality, the majority (15A, 22F, 17F, 11A, 13, 35B) are not included in the current conjugate vaccines.
PNEUMOTAC: A HIGH-THROUGHPUT PLATFORM FOR SEROTYPING STREPTOCOCCUS PNEUMONIAE (ID 242)
Abstract
Background
Sensitive, high-throughput platforms, for pneumococcal serotyping are essential for vaccine effectiveness studies. We developed PneumoTAC, a TaqMan array card (TAC) platform for the rapid identification of most S. pneumoniae serotypes.
Methods
PneumoTAC reactions underwent a thorough analytical validation including studies of limit of detection (LOD) and sensitivity. The performance of PneumoTAC was investigated on blinded pneumococcal isolates (N=131), and in N=84 clinical specimens from pneumococcal disease episodes [cerebrospinal fluid samples (CSF, N=71), and blood cultures (N=13)].
Results
The LOD of assays in PneumoTAC spanned between 2 and 21.4 genome equivalents. A sensitivity of 100%, and 98.8%, was achieved for S. pneumoniae species confirmation using DNA from isolates, and clinical specimens, respectively. The sensitivity for the detection of the serotypes/serogroups was 94% using DNA from isolates. In clinical specimens PneumoTAC detected a serotype in N=80 (96.3%) of samples, whereas a multiplex (m)PCR approach detected a serotype in N=55 (66%) of specimens. The correlation between the serotype obtained by mPCR and that obtained by PneumoTAC was 96.3% (N=53).
Conclusions
We developed PneumoTAC a multi-target platform with increased serotype coverage, compared to other TAC assays and multiplex PCR approaches, to identify 94 S. pneumoniae serotypes/serogroups in a single run.