ArticleEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin2020
Two multi-fragment recombination events resulted in the β-lactam-resistant serotype 11A-ST6521 related to Spain9V-ST156 pneumococcal clone spreading in south-western Europe, 2008 to 2016.
Article in Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Global trends in macrolide and lincosamide resistance in Streptococcus species: a comprehensive systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Emergence of antibiotic-resistant pneumococcal serotypes causing invasive pneumococcal disease in children, Spain.Antimicrobial agents and chemotherapy · 2026Article
- Amoxicillin-non-susceptibleAntimicrobial agents and chemotherapy · 2025Observational
- Antimicrobial activity of β-lactam antibiotics against pneumococcal isolates causing pneumococcal disease in adults immediately before and after the COVID-19 pandemic in Spain (2019-2020).Frontiers in pharmacology · 2025Article
- SARS-CoV-2 andFrontiers in cellular and infection microbiology · 2025Observational
- Dynamics of Antibiotic Resistance ofAntibiotics (Basel, Switzerland) · 2023Article
- Pneumococcal Serotype Evolution and Burden in European Adults in the Last Decade: A Systematic Review.Microorganisms · 2023Review
- Evolution of Antimicrobial Susceptibility to Penicillin in Invasive Strains ofAntibiotics (Basel, Switzerland) · 2023Article
- Sequence-type diversity of invasive Streptococcus pneumoniae isolates in Iran among children under 15 years of age.GMS hygiene and infection control · 2023Article
- Adult non-invasive pneumococcal pneumonia in Portugal is dominated by serotype 3 and non-PCV13 serotypes 3-years after near universal PCV13 use in children.Frontiers in public health · 2023Article
- Molecular epidemiology of paediatric invasive pneumococcal disease in Andalusia, Spain.Epidemiology and infection · 2022Article
- Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13.Microbiology spectrum · 2021Article
- Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines.Microorganisms · 2021Article
- Pharmacokinetic/pharmacodynamic evaluation of the antimicrobial therapy of pneumococcal invasive disease in adults in post-PCV13 vaccine period in Madrid, Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Immunization with SP_1992 (DiiA) Protein ofVaccines · 2021Article
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Authors and funding
18 authors at 11 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BackgroundThe successful pneumococcal clone Spain9V-ST156 (PMEN3) is usually associated with vaccine serotypes 9V and 14.AimOur objective was to analyse the increase of a serotype 11A variant of PMEN3 as cause of invasive pneumococcal disease (IPD) in Spain and its spread in south-western Europe.MethodsWe conducted a prospective multicentre study of adult IPD in Spain (2008-16). Furthermore, a subset of 61 penicillin-resistant serotype 11A isolates from France, Italy, Portugal and Spain were subjected to whole genome sequencing (WGS) and compared with 238 genomes from the European Nucleotide Archive (ENA).ResultsAlthough the incidence of serotype 11A in IPD was stable, a clonal shift was detected from CC62 (penicillin-susceptible) to CC156 (penicillin-resistant). By WGS, three major 11A-CC156 lineages were identified, linked to ST156 (n = 5 isolates; France, Italy and Portugal), ST166 (n = 4 isolates; France and Portugal) and ST838/6521 (n = 52 isolates; France, Portugal and Spain). Acquisition of the 11A capsule allowed to escape vaccine effect. AP200 (11A-ST62) was the donor for ST156 and ST838/6521 but not for ST166. In-depth analysis of ST838/6521 lineage showed two multi-fragment recombination events including four and seven fragments from an 11A-ST62 and an NT-ST344 representative, respectively.ConclusionThe increase in penicillin-resistant serotype 11A IPD in Spain was linked to the spread of a vaccine escape PMEN3 recombinant clone. Several recombination events were observed in PMEN3 acquiring an 11A capsule. The most successful 11A-PMEN3 lineage spreading in south-western Europe appeared after two multi-fragment recombination events with representatives of two major pneumococcal clones (11A-ST62 and NT-ST344).
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