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The bacterial pathogen Streptococcus pneumoniae is a major public health concern, being responsible for more than 1.5 million deaths annually through pneumonia, meningitis, and septicemia. Available vaccines target only a subset of serotypes, so vaccination is often accompanied by a rise in the frequency of nonvaccine serotypes. Epidemiological studies suggest that such a change in serotype frequencies is often coupled with an increase of antibiotic resistance among nonvaccine serotypes. Building on previous multilocus models for bacterial pathogen population structure, we have developed a theoretical framework incorporating variation of serotype and antibiotic resistance to examine how their associations may be affected by vaccination. Using this framework, we find that vaccination can result in a rapid increase in the frequency of preexisting resistant variants of nonvaccine serotypes due to the removal of competition from vaccine serotypes.

Original publication

DOI

10.1073/pnas.1718712115

Type

Journal article

Journal

Proc Natl Acad Sci U S A

Publication Date

20/03/2018

Volume

115

Pages

3102 - 3107

Keywords

Streptococcus pneumoniae, antibiotic resistance, ecological competition, epidemiology, mathematical model, Anti-Bacterial Agents, Computer Simulation, Drug Resistance, Bacterial, Humans, Models, Biological, Pneumococcal Infections, Pneumococcal Vaccines, Serogroup, Streptococcus pneumoniae, Vaccination, Vaccines, Conjugate