Hajji Karim, Wróbel-Pawelczyk Izabela, van Veldhuizen Janieke, Maruhn Karsten, Miellet Willem R, Mariman Rob, Steens Anneke, van Sorge Nina M, Trzciński Krzysztof, van der Linden Mark P G, Skoczyńska Anna, Visser Linda J
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland.
J Infect. 2025 Jul;91(1):106519. doi: 10.1016/j.jinf.2025.106519. Epub 2025 May 26.
Streptococcus pneumoniae is a major cause of community-acquired pneumonia and invasive diseases. Vaccination prevents pneumococcal disease caused by vaccine serotypes but leads to an increase in disease caused by non-vaccine serotypes. We aimed to characterise serotype 38 isolates from invasive pneumococcal disease (IPD) patients in Germany, Poland and the Netherlands to explain a recent surge in cases.
IPD surveillance data from 2013/2014 to 2023/2024 were reviewed in all three countries for trends in serotype 38 incidence. Collected isolates were serotyped and phenotypically tested for antimicrobial resistance. Selected serotype 38 isolates (n=130) were sequenced and subjected to phylogenetic analysis, along with 213 publicly available genomes, and characterised according to their virulence and resistance genes.
Surveillance data revealed an increase in the percentage of serotype 38 in IPD in Germany and Poland in 2023/2024. This was most pronounced among children aged 0-4 years (from 4.3% to 17.1% and 4.0% to 15.8% of IPD cases, respectively) and adults aged ≥60 years (from 1.5% to 7.0% and from 0.7% to 2.9%, respectively). No such rise in serotype 38 IPD was observed in the Netherlands. Phylogenetic analysis showed that recent isolates mostly emerged from previously circulating strains, showed no significant changes in gene content and carried little antimicrobial resistance genes.
The recent surge in non-vaccine serotype 38 among IPD cases in Germany and Poland cannot be explained by changes in antimicrobial resistance or other genetic changes. Our study underscores the importance of international collaboration in monitoring pneumococcal serotype trends to inform policymakers.
肺炎链球菌是社区获得性肺炎和侵袭性疾病的主要病因。接种疫苗可预防由疫苗血清型引起的肺炎球菌疾病，但会导致非疫苗血清型引起的疾病增加。我们旨在对德国、波兰和荷兰侵袭性肺炎球菌疾病（IPD）患者的38型分离株进行特征分析，以解释近期病例的激增。
回顾了这三个国家2013/2014年至2023/2024年的IPD监测数据，以了解38型发病率的趋势。对收集的分离株进行血清分型，并进行抗菌药物耐药性的表型检测。选择38型分离株（n = 130）进行测序，并与213个公开可用的基因组一起进行系统发育分析，并根据其毒力和耐药基因进行特征分析。
监测数据显示，2023/2024年德国和波兰IPD中38型的百分比有所增加。这在0至4岁儿童中最为明显（分别从IPD病例的4.3%增至17.1%和4.0%增至15.8%）以及60岁及以上成年人中（分别从1.5%增至7.0%和从0.7%增至2.9%）。荷兰未观察到38型IPD的此类上升。系统发育分析表明，近期分离株大多源自先前流行的菌株，基因含量无显著变化，且携带的抗菌药物耐药基因很少。
德国和波兰IPD病例中近期非疫苗血清型38的激增无法用抗菌药物耐药性变化或其他基因变化来解释。我们的研究强调了国际合作在监测肺炎球菌血清型趋势以告知政策制定者方面的重要性。
