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利用侵袭性疾病数据和反侵袭性加权预测 PCV13 后肺炎链球菌的进化。

Prediction of post-PCV13 pneumococcal evolution using invasive disease data enhanced by inverse-invasiveness weighting.

机构信息

Center for Communicable Disease Dynamics, Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

mBio. 2024 Oct 16;15(10):e0335523. doi: 10.1128/mbio.03355-23. Epub 2024 Aug 29.

Abstract

After introducing pneumococcal conjugate vaccines (PCVs), serotype replacement occurred in . Predicting which pneumococcal strains will become common in carriage after vaccination can enhance vaccine design, public health interventions, and understanding of pneumococcal evolution. Invasive pneumococcal isolates were collected during 1998-2018 by the Active Bacterial Core surveillance (ABCs). Carriage data from Massachusetts (MA) and Southwest United States were used to calculate weights. Using pre-vaccine data, serotype-specific inverse-invasiveness weights were defined as the ratio of the proportion of the serotype in carriage to the proportion in invasive data. Genomic data were processed under bioinformatic pipelines to define genetically similar sequence clusters (i.e., strains), and accessory genes (COGs) present in 5-95% of isolates. Weights were applied to adjust observed strain proportions and COG frequencies. The negative frequency-dependent selection (NFDS) model predicted strain proportions by calculating the post-vaccine strain composition in the weighted invasive disease population that would best match pre-vaccine COG frequencies. Inverse-invasiveness weighting increased the correlation of COG frequencies between invasive and carriage data in linear or logit scale for pre-vaccine, post-PCV7, and post-PCV13; and between different epochs in the invasive data. Weighting the invasive data significantly improved the NFDS model's accuracy in predicting strain proportions in the carriage population in the post-PCV13 epoch, with the adjusted increasing from 0.254 before weighting to 0.545 after weighting. The weighting system adjusted invasive disease data to better represent the pneumococcal carriage population, allowing the NFDS mechanism to predict strain proportions in carriage in the post-PCV13 epoch. Our methods enrich the value of genomic sequences from invasive disease surveillance.IMPORTANCE, a common colonizer in the human nasopharynx, can cause invasive diseases including pneumonia, bacteremia, and meningitis mostly in children under 5 years or older adults. The PCV7 was introduced in 2000 in the United States within the pediatric population to prevent disease and reduce deaths, followed by PCV13 in 2010, PCV15 in 2022, and PCV20 in 2023. After the removal of vaccine serotypes, the prevalence of carriage remained stable as the vacated pediatric ecological niche was filled with certain non-vaccine serotypes. Predicting which pneumococcal clones, and which serotypes, will be most successful in colonization after vaccination can enhance vaccine design and public health interventions, while also improving our understanding of pneumococcal evolution. While carriage data, which are collected from the pneumococcal population that is competing to colonize and transmit, are most directly relevant to evolutionary studies, invasive disease data are often more plentiful. Previously, evolutionary models based on negative frequency-dependent selection (NFDS) on the accessory genome were shown to predict which non-vaccine strains and serotypes were most successful in colonization following the introduction of PCV7. Here, we show that an inverse-invasiveness weighting system applied to invasive disease surveillance data allows the NFDS model to predict strain proportions in the projected carriage population in the post-PCV13/pre-PCV15 and pre-PCV20 epoch. The significance of our research lies in using a sample of invasive disease surveillance data to extend the use of NFDS as an evolutionary mechanism to predict post-PCV13 population dynamics. This has shown that we can correct for biased sampling that arises from differences in virulence and can enrich the value of genomic data from disease surveillance and advance our understanding of how NFDS impacts carriage population dynamics after both PCV7 and PCV13 vaccination.

摘要

在引入肺炎球菌结合疫苗 (PCV) 后,血清型发生了替代。预测接种疫苗后哪些肺炎球菌菌株将成为常见的带菌者,可以增强疫苗设计、公共卫生干预措施,并了解肺炎球菌的进化。通过主动细菌核心监测 (ABCs) 在 1998 年至 2018 年期间收集了侵袭性肺炎球菌分离株。使用马萨诸塞州 (MA) 和美国西南部的带菌者数据来计算权重。使用疫苗前数据,定义了血清型特异性反侵袭性权重,即血清型在带菌者中的比例与侵袭性数据中比例的比值。基因组数据在生物信息学管道下进行处理,以定义遗传相似的序列簇(即菌株)和存在于 5-95%分离株中的辅助基因 (COG)。应用权重来调整观察到的菌株比例和 COG 频率。负频率依赖性选择 (NFDS) 模型通过计算加权侵袭性疾病人群中接种疫苗后最能匹配疫苗前 COG 频率的菌株组成来预测菌株比例。反侵袭性加权提高了线性或对数尺度上疫苗前、PCV7 后和 PCV13 后侵袭性和带菌者数据之间以及侵袭性数据中不同时期之间 COG 频率的相关性。加权侵袭性数据显著提高了 NFDS 模型在预测 PCV13 后带菌者人群中菌株比例的准确性,调整后的 从加权前的 0.254 增加到加权后的 0.545。加权系统调整了侵袭性疾病数据,以更好地代表肺炎球菌带菌者人群,使 NFDS 机制能够预测 PCV13 后带菌者人群中的菌株比例。我们的方法丰富了侵袭性疾病监测中基因组序列的价值。

意义,一种常见的人类鼻咽部定植菌,可引起侵袭性疾病,包括肺炎、菌血症和脑膜炎,主要发生在 5 岁以下儿童或老年人中。PCV7 于 2000 年在美国引入儿科人群,以预防疾病和减少死亡,随后于 2010 年引入 PCV13、2022 年引入 PCV15 和 2023 年引入 PCV20。在去除疫苗血清型后,由于空出的儿科生态位被某些非疫苗血清型填补,带菌者的患病率保持稳定。预测哪些肺炎球菌克隆和哪些血清型在接种疫苗后最成功地定植,可以增强疫苗设计和公共卫生干预措施,同时提高我们对肺炎球菌进化的理解。虽然来自竞争定植和传播的肺炎球菌人群的带菌者数据与进化研究最直接相关,但侵袭性疾病数据通常更为丰富。以前,基于辅助基因组的负频率依赖性选择 (NFDS) 的进化模型已被证明可以预测 PCV7 引入后哪些非疫苗菌株和血清型最成功地定植。在这里,我们表明,应用于侵袭性疾病监测数据的反侵袭性加权系统允许 NFDS 模型预测 PCV13/PCV15 后和 PCV20 前时期预计带菌者人群中的菌株比例。我们研究的意义在于使用侵袭性疾病监测数据样本来扩展 NFDS 作为一种进化机制的使用,以预测 PCV13 后的种群动态。这表明我们可以纠正由于毒力差异引起的偏向性采样,并丰富疾病监测中基因组数据的价值,从而推进我们对 NFDS 如何影响 PCV7 和 PCV13 接种后带菌者人群动态的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d98/11481909/7ec713e4052b/mbio.03355-23.f001.jpg

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