Molecular Characterization of Streptococcus pneumoniae Serotype 12F Isolates Associated with Rural Community Outbreaks in Alaska

Arctic Investigations Program, DPEI, NCEZID, Centers for Disease Control and Prevention, 4055 Tudor Centre Drive, Anchorage, AK, 99508, USA.
Journal of clinical microbiology (Impact Factor: 3.99). 04/2013; 51(5):1402-1407. DOI: 10.1128/JCM.02880-12
Source: PubMed


Outbreaks of invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae serotype 12F were observed in two neighboring regions of rural Alaska in 2003 to 2006 and 2006 to 2008. IPD surveillance
data from 1986 to 2009 and carriage survey data from 1998 to 2004 and 2008 to 2009 were reviewed to identify patterns of serotype
12F transmission. Pulsed-field gel electrophoresis was performed on all available isolates, and selected isolates were characterized
by additional genetic subtyping methods. Serotype 12F IPD occurred in two waves in Alaska between 1986 and 2008. While cases
of disease occurred nearly every year in Anchorage, in rural regions, 12F IPD occurred with rates 10- to 20-fold higher than
those in Anchorage, often with many years between disease peaks and generally caused by a single predominant genetic clone.
Carriage occurred predominantly in adults, except early in the rural outbreaks, when most carriage was in persons <18 years
old. In rural regions, carriage of 12F disappeared completely after outbreaks. Different 12F clones appear to have been introduced
episodically into rural populations, spread widely in young, immunologically naïve populations (leading to outbreaks of IPD
lasting 1 to 3 years), and then disappeared rapidly from the population. Larger population centers might have been the reservoir
for these clones. This epidemiologic pattern is consistent with a highly virulent, but immunogenic, form of pneumococcus.

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