ArticleThe Lancet regional health. Europe2024
Evolution of invasive pneumococcal disease by serotype 3 in adults: a Spanish three-decade retrospective study.
Article in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pneumococcal serotypes and their association with death risk in invasive pneumococcal disease: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- An overview of the clinical development of the 20-valent pneumococcal conjugate vaccine in adults.Human vaccines & immunotherapeutics · 2026Review
- Baseline Predictors of Adverse Outcome and Survival in Adults Hospitalized with Invasive Pneumococcal Disease.Healthcare (Basel, Switzerland) · 2026Article
- Metabolic rewiring at the pyruvate node contributes to severe pneumonia and attenuation of T cell responses in serotype 3 Streptococcus pneumoniae infection.Respiratory research · 2026Article
- Persistence of vaccine-induced serotype-related pathology in invasive pneumococcal disease in children. Community of Madrid, 2007-2024.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Genomic characterization of invasive disease-causingMicrobial genomics · 2026Article
- Metabolic Rewiring at the Pyruvate Node Drives Severe Pneumonia and T-Cell Suppression in Serotype 3bioRxiv : the preprint server for biology · 2026Article
- Preliminary genomic assessment of invasive Streptococcus pneumoniae serotype 3 isolates in Malaysia.BMC genomic data · 2026Article
- Article
- Article
- Hidden burden of pneumococcal colonization in adults with viral respiratory infections: the role of influenza and RSV.Frontiers in cellular and infection microbiology · 2026Article
- Molecular Epidemiology, Antimicrobial Resistance, and Clinical Characteristics ofAntibiotics (Basel, Switzerland) · 2025Article
- Diabetes mellitus and invasive pneumococcal disease in Spain: a retrospective study.BMC infectious diseases · 2025Article
- Genomic analysis and pneumococcal population dynamics across PCV implementation in South Korea, 1997-2023.Microbial genomics · 2025Article
- Intra-serotype variation ofMicrobiology spectrum · 2025Article
- Fluorescent antibody-based detection and ultrastructural analysis of Streptococcus pneumoniae in human sputum.Pneumonia (Nathan Qld.) · 2025Article
- Respiratory infections in the post-COVID-19 era: impact, prevalence, and clinical characteristics of bacterial and viral co-infections.Frontiers in medicine · 2025Article
- Fourier-transform infrared spectroscopy for rapidFrontiers in microbiology · 2025Article
- SARS-CoV-2 andFrontiers in cellular and infection microbiology · 2025Observational
- Antibodies against polysaccharide type 3 and pneumococcal proteins demonstrate synergistic protective effect in a highly virulent type 3 invasive disease model in mice.Frontiers in immunology · 2025Article
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Authors and funding
21 authors.
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Abstract
Background: Invasive pneumococcal disease due to serotype 3 (S3-IPD) is associated with high mortality rates and long-term adverse effects. The introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into the Spanish paediatric immunisation programme has not led to a decrease in the adult S3-IPD. We aimed to analyse the incidence, clinical characteristics and genomics of S3-IPD in adults in Spain. Methods: Adult IPD episodes hospitalized in a Southern Barcelona hospital were prospectively collected (1994-2020). For genomic comparison, S3-IPD isolates from six Spanish hospitals (2008-2020) and historical isolates (1989-1993) were analysed by WGS (Illumina and/or MinION). Findings: From 1994 to 2020, 270 S3-IPD episodes were detected. When comparing pre-PCV (1994-2001) and late-PCV13 (2016-2020) periods, only modest changes in S3-IPD were observed (from 1.58 to 1.28 episodes per 100,000 inhabitants year). In this period, the incidence of the two main lineages shifted from 0.38 to 0.67 (CC180-GPSC12) and from 1.18 to 0.55 (CC260-GPSC83). The overall 30-day mortality remained high (24.1%), though a decrease was observed between the pre-PCV (32.4%; 95.0% CI, 22.0-45.0) and the late-PCV13 period (16.7%; 95.0% CI, 7.5-32.0) (p = 0.06). At the same time, comorbidities increased from 77.3% (95.0% CI, 65.0-86.0) to 85.7% (95.0% CI, 71.0-94.0) (p = 0.69). There were no differences in clinical characteristics or 30-day mortality between the two S3 lineages. Although both lineages were genetically homogeneous, the CC180-GPSC12 lineage presented a higher SNP density, a more open pan-genome, and a major presence of prophages and mobile genetic elements carrying resistance genes. Interpretation: Adult S3-IPD remained stable in our area over the study period despite PCV13 introduction in children. However, a clonal shift was observed. The decrease in mortality rates and the increase in comorbidities suggest a change in clinical management and overall population characteristics. The low genetic variability and absence of clinical differences between lineages highlight the role of the S3 capsule in the disease severity. Funding: This study has been funded by Instituto de Salud Carlos III (ISCIII) "PI18/00339", "PI21/01000", "INT22/00096", "FI22/00279", CIBER "CIBERES-CB06/06/0037", "CIBERINFEC-CB21/13/00009" and MSD grant "IISP 60168".
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