Volume 21, Number 11—November 2015
Research
Serotype Changes and Drug Resistance in Invasive Pneumococcal Diseases in Adults after Vaccinations in Children, Japan, 2010–2013
Kimiko Ubukata
, Naoko Chiba, Shigeo Hanada, Miyuki Morozumi, Takeaki Wajima, Michi Shouji, Satoshi Iwata, and Invasive Pneumococcal Diseases Surveillance Study Group
, Naoko Chiba, Shigeo Hanada, Miyuki Morozumi, Takeaki Wajima, Michi Shouji, Satoshi Iwata, and Invasive Pneumococcal Diseases Surveillance Study Group
Table 4
Pneumococcal serotypes by type of invasive pneumococcal diseases in adults, Japan, April 2010–March 2013*
| Serotype | Pneumonia, no. (%), n = 375 | Bacteremia and sepsis, no. (%), n = 172 | Meningitis, no. (%), n = 127 | Others, no. %, n = 41 | Total, no. (%), n = 715 | p value† |
|---|---|---|---|---|---|---|
| PCV7 serotypes | ||||||
| 4 | 25 (6.7) | 8 (4.7) | 5 (3.9) | 0 | 38 (5.3) | 0.403 |
| 6B | 42 (11.2) | 20 (11.6) | 11 (8.7) | 4 (9.8) | 77 (10.8) | 0.667 |
| 9V | 10 (2.7) | 3 (1.7) | 0 | 0 | 13 (1.8) | 0.161 |
| 14 | 36 (9.6) | 9 (5.2) | 6 (4.7) | 3 (7.3) | 54 (7.6) | 0.076 |
| 18C | 1 (0.3) | 1 (0.6) | 1 (0.8) | 0 | 3 (0.4) | ND |
| 19F | 14 (3.7) | 9 (5.2) | 4 (3.1) | 2 (4.9) | 29 (4.1) | 0.617 |
| 23F | 16 (4.3) | 7 (4.1) | 15 (11.8) | 5 (12.2) | 43 (6.0) | 0.004 |
| Total |
144 (38.4) |
57 (32.6) |
42 (32.3) |
14 (34.1) |
257 (35.5) |
0.325 |
| Additional PCV13 serotypes | ||||||
| 3 | 84 (22.4) | 17 (9.9) | 7 (5.5) | 6 (14.6) | 114 (15.9) | <0.001 |
| 6A | 7 (1.9) | 9 (5.2) | 4 (3.1) | 1 (2.4) | 21 (2.9) | 0.101 |
| 7F | 10 (2.7) | 2 (1.2) | 2 (1.6) | 0 | 14 (2.0) | 0.463 |
| 19A | 32 (8.5) | 9 (5.2) | 3 (2.4) | 2 (4.9) | 46 (6.4) | 0.035 |
| Other‡ | 0 | 3 (1.7) | 0 | 0 | 3 (0.4) | ND |
| Total |
277 (73.9) |
97 (56.4) |
58 (45.7) |
23 (56.1) |
455 (63.6) |
<0.001 |
| Additional PPSV23 serotypes | ||||||
| 10A | 6 (1.6) | 8 (4.7) | 11 (8.7) | 4 (9.8) | 29 (4.1) | 0.001 |
| 11A | 10 (2.7) | 3 (1.7) | 3 (2.4) | 0 | 16 (2.2) | 0.798 |
| 15B | 4 (1.1) | 4 (2.3) | 2 (1.6) | 2 (4.9) | 12 (1.7) | 0.533 |
| 22F | 20 (5.3) | 12 (7.0) | 12 (9.4) | 3 (7.3) | 47 (6.6) | 0.269 |
| Other§ | 6 (1.6) | 4 (2.3) | 6 (4.7) | 1 (2.4) | 17 (2.4) | 0.139 |
| Total¶ |
316 (84.3) |
119 (69.2) |
88 (69.3) |
32 (78.0) |
555 (77.6) |
<0.001 |
| Nonvaccine serotypes | ||||||
| 6C | 21 (5.6) | 10 (5.8) | 7 (5.5) | 4 (9.8) | 42 (5.9) | 0.994 |
| 15A | 5 (1.3) | 9 (5.2) | 9 (7.1) | 1 (2.4) | 24 (3.4) | 0.003 |
| 15C | 1 (0.3) | 4 (2.3) | 3 (2.4) | 0 | 8 (1.1) | ND |
| 23A | 2 (0.5) | 7 (4.1) | 8 (6.3) | 1 (2.4) | 18 (2.5) | <0.001 |
| 35B | 7 (1.9) | 9 (5.2) | 4 (3.1) | 2 (4.9) | 22 (3.1) | 0.101 |
| 38 | 6 (1.6) | 1 (0.6) | 1 (0.8) | 0 | 8 (1.1) | ND |
| Other# | 7 (1.9) | 4 (2.3) | 3 (2.4) | 0 | 14 (2.0) | 0.918 |
| Total |
49 (13.1) |
44 (25.6) |
35 (27.6) |
8 (19.5) |
136 (19.0) |
<0.001 |
| Nontypeable** | 3 (0.8) | 0 | 0 | 0 | 3 (0.4) | |
*ND, not determined because of low number of strains. PCV7, 7-valent pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine.
†Significant difference obtained by comparing pneumonia, sepsis, and meningitis.
‡Serotypes 1 and 5.
§Serotypes 12F, 20, and 33F.
¶Serotype 6A is not included in PPSV23.
#Serotypes 6D, 7C, 16F, 18B, 24F, 34, and 37.
**Serotypes that were excluded from the statistical analysis because they were unclassifiable.
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