The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease

© 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Background. Different clinical manifestations of invasive pneumococcal disease (IPD) have thus far mainly been explained by patient characteristics. Here we studied the...

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Main Authors: Cremers, A.J.H., Mobegi, Fredrick, Van Der Gaast-De Jongh, C., Van Weert, M., Van Opzeeland, F.J., Vehkala, M., Knol, M.J., Bootsma, H.J., Välimäki, N., Croucher, N.J., Meis, J.F., Bentley, S., Van Hijum, S.A.F.T., Corander, J., Zomer, A.L., Ferwerda, G., De Jonge, M.I.
Format: Journal Article
Language:English
Published: OXFORD UNIV PRESS INC 2018
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/80729
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author Cremers, A.J.H.
Mobegi, Fredrick
Van Der Gaast-De Jongh, C.
Van Weert, M.
Van Opzeeland, F.J.
Vehkala, M.
Knol, M.J.
Bootsma, H.J.
Välimäki, N.
Croucher, N.J.
Meis, J.F.
Bentley, S.
Van Hijum, S.A.F.T.
Corander, J.
Zomer, A.L.
Ferwerda, G.
De Jonge, M.I.
author_facet Cremers, A.J.H.
Mobegi, Fredrick
Van Der Gaast-De Jongh, C.
Van Weert, M.
Van Opzeeland, F.J.
Vehkala, M.
Knol, M.J.
Bootsma, H.J.
Välimäki, N.
Croucher, N.J.
Meis, J.F.
Bentley, S.
Van Hijum, S.A.F.T.
Corander, J.
Zomer, A.L.
Ferwerda, G.
De Jonge, M.I.
author_sort Cremers, A.J.H.
building Curtin Institutional Repository
collection Online Access
description © 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Background. Different clinical manifestations of invasive pneumococcal disease (IPD) have thus far mainly been explained by patient characteristics. Here we studied the contribution of pneumococcal genetic variation to IPD phenotype. Methods. The index cohort consisted of 349 patients admitted to 2 Dutch hospitals between 2000-2011 with pneumococcal bacteremia. We performed genome-wide association studies to identify pneumococcal lineages, genes, and allelic variants associated with 23 clinical IPD phenotypes. The identified associations were validated in a nationwide (n = 482) and a post-pneumococcal vaccination cohort (n = 121). The contribution of confirmed pneumococcal genotypes to the clinical IPD phenotype, relative to known clinical predictors, was tested by regression analysis. Results. Among IPD patients, the presence of pneumococcal gene slaA was a nationwide confirmed independent predictor of meningitis (odds ratio [OR], 10.5; P = .001), as was sequence cluster 9 (serotype 7F: OR, 3.68; P = .057). A set of 4 pneumococcal genes co-located on a prophage was a confirmed independent predictor of 30-day mortality (OR, 3.4; P = .003). We could detect the pneumococcal variants of concern in these patients' blood samples. Conclusions. In this study, knowledge of pneumococcal genotypic variants improved the clinical risk assessment for detrimental manifestations of IPD. This provides us with novel opportunities to target, anticipate, or avert the pathogenic effects related to particular pneumococcal variants, and indicates that information on pneumococcal genotype is important for the diagnostic and treatment strategy in IPD. Ongoing surveillance is warranted to monitor the clinical value of information on pneumococcal variants in dynamic microbial and susceptible host populations.
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spelling curtin-20.500.11937-807292021-01-15T04:28:59Z The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease Cremers, A.J.H. Mobegi, Fredrick Van Der Gaast-De Jongh, C. Van Weert, M. Van Opzeeland, F.J. Vehkala, M. Knol, M.J. Bootsma, H.J. Välimäki, N. Croucher, N.J. Meis, J.F. Bentley, S. Van Hijum, S.A.F.T. Corander, J. Zomer, A.L. Ferwerda, G. De Jonge, M.I. Science & Technology Life Sciences & Biomedicine Immunology Infectious Diseases Microbiology invasive pneumococcal disease bacterial genomics genome-wide association study clinical prediction molecular diagnostics COMMUNITY-ACQUIRED PNEUMONIA CONJUGATE VACCINATION BACTERIAL-MENINGITIS SEROTYPE PATHOGENESIS ASSOCIATION BACTEREMIA CHILDREN BURDEN DEATH © 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Background. Different clinical manifestations of invasive pneumococcal disease (IPD) have thus far mainly been explained by patient characteristics. Here we studied the contribution of pneumococcal genetic variation to IPD phenotype. Methods. The index cohort consisted of 349 patients admitted to 2 Dutch hospitals between 2000-2011 with pneumococcal bacteremia. We performed genome-wide association studies to identify pneumococcal lineages, genes, and allelic variants associated with 23 clinical IPD phenotypes. The identified associations were validated in a nationwide (n = 482) and a post-pneumococcal vaccination cohort (n = 121). The contribution of confirmed pneumococcal genotypes to the clinical IPD phenotype, relative to known clinical predictors, was tested by regression analysis. Results. Among IPD patients, the presence of pneumococcal gene slaA was a nationwide confirmed independent predictor of meningitis (odds ratio [OR], 10.5; P = .001), as was sequence cluster 9 (serotype 7F: OR, 3.68; P = .057). A set of 4 pneumococcal genes co-located on a prophage was a confirmed independent predictor of 30-day mortality (OR, 3.4; P = .003). We could detect the pneumococcal variants of concern in these patients' blood samples. Conclusions. In this study, knowledge of pneumococcal genotypic variants improved the clinical risk assessment for detrimental manifestations of IPD. This provides us with novel opportunities to target, anticipate, or avert the pathogenic effects related to particular pneumococcal variants, and indicates that information on pneumococcal genotype is important for the diagnostic and treatment strategy in IPD. Ongoing surveillance is warranted to monitor the clinical value of information on pneumococcal variants in dynamic microbial and susceptible host populations. 2018 Journal Article http://hdl.handle.net/20.500.11937/80729 10.1093/cid/ciy417 English OXFORD UNIV PRESS INC restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
invasive pneumococcal disease
bacterial genomics
genome-wide association study
clinical prediction
molecular diagnostics
COMMUNITY-ACQUIRED PNEUMONIA
CONJUGATE VACCINATION
BACTERIAL-MENINGITIS
SEROTYPE
PATHOGENESIS
ASSOCIATION
BACTEREMIA
CHILDREN
BURDEN
DEATH
Cremers, A.J.H.
Mobegi, Fredrick
Van Der Gaast-De Jongh, C.
Van Weert, M.
Van Opzeeland, F.J.
Vehkala, M.
Knol, M.J.
Bootsma, H.J.
Välimäki, N.
Croucher, N.J.
Meis, J.F.
Bentley, S.
Van Hijum, S.A.F.T.
Corander, J.
Zomer, A.L.
Ferwerda, G.
De Jonge, M.I.
The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title_full The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title_fullStr The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title_full_unstemmed The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title_short The contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
title_sort contribution of genetic variation of streptococcus pneumoniae to the clinical manifestation of invasive pneumococcal disease
topic Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
invasive pneumococcal disease
bacterial genomics
genome-wide association study
clinical prediction
molecular diagnostics
COMMUNITY-ACQUIRED PNEUMONIA
CONJUGATE VACCINATION
BACTERIAL-MENINGITIS
SEROTYPE
PATHOGENESIS
ASSOCIATION
BACTEREMIA
CHILDREN
BURDEN
DEATH
url http://hdl.handle.net/20.500.11937/80729