Evidence map›Paper›PMID 39259351›Full record

ArticleThe Journal of infectious diseases2025

Increased Proportions of Invasive Pneumococcal Disease Cases Among Adults Experiencing Homelessness Sets the Stage for New Serotype 4 Capsular-Switch Recombinants.

Bernard Beall, Sopio Chochua, Ben Metcalf, Wuling Lin, Theresa Tran, Zhongya Li, Yuan Li, Meghan L Bentz, Mili Sheth, Gunars Osis and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Increase in serotypes 4 and 14 in invasive pneumococcal disease in adults aged 18 to 59 years. A retrospective population-based descriptive study during the period 2007-2025 in the Community of Madrid, Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  2. Invasive pneumococcal disease surveillance in Canada, 2023.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2026
    Article
  3. Review
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Bernard BeallContractor to Division of Bacterial Diseases, Centers for Disease Control and Prevention, Eagle Global Scientific, LLC, Atlanta, Georgia, USA.ORCID 0000-0001-5315-1070
Sopio ChochuaRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-8222-7353
Ben MetcalfRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Wuling LinRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Theresa TranRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Zhongya LiRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Yuan LiRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-2331-2694
Meghan L BentzBiotechnology Core Facility Branch, Division of Core Laboratory Services and Response, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Mili ShethBiotechnology Core Facility Branch, Division of Core Laboratory Services and Response, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Gunars OsisContractor to National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Lesley McGeeRespiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Funding

CDC HHSIntramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundThe Centers for Disease Control and Prevention's Active Bacterial Core surveillance (ABCs) identified increased serotype 4 invasive pneumococcal disease (IPD), particularly among adults experiencing homelessness (AEH).

methodsWe quantified increased proportions of IPD cases in AEH during 2016-2022. Employing genomic-based characterization of IPD isolates, we identified serotype-switch variants. Recombinational analyses were used to identify the genetic donor and recipient strain that generated a serotype 4 progeny strain. We performed phylogenetic analyses of the serotype 4 progeny and of the serotype 12F genetic recipient to determine genetic distances.

resultsWe identified a cluster of 30 highly related (0-21 nucleotide differences) IPD isolates recovered during 2022-2023, corresponding to a serotype 4 capsular-switch variant. This strain arose through a multifragment recombination event between serotype 4/ST10172 and serotype 12F/ST220 parental strains. Twenty-five of the 30 cases occurred in Oregon. Of 29 cases with known residence status, 16 occurred in AEH. Variant emergence coincided with a 2.6-fold increase (57 to 148) of cases caused by the serotype 4/ST10172 donor lineage in 2022 compared to 2019 and its first appearance in Oregon. Most serotypes showed sequential increases of AEH IPD/all IPD ratios during 2016-2022 (eg, for all serotypes combined, 247/2198, 11.2% during 2022 compared to 405/5317, 7.6% for 2018-2019, P < .001). Serotypes 4 and 12F each caused more IPD than any other serotype in AEH during 2020-2022 (207 combined case isolates accounting for 38% of all IPD in AEH).

conclusionsExpansion and increased transmission of serotypes 4 and 12F among adults potentially led to recent genesis of an impactful hybrid serotype-switch variant.

Indexed as

Bacterial CapsulesIll-Housed PersonsPneumococcal InfectionsRecombination, GeneticStreptococcus pneumoniaeAdultFemaleHumansMaleMiddle AgedOregonPhylogenySerogroupadults experiencing homelessnessinvasive pneumococcal diseasemultifragment recombinationserotype switch variantwestern Active Bacterial Core Surveillance sites

Identifiers

PMID39259351
PMCPMC11893508

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.