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Evolution of pneumococcal serotype 19A in children in Bangladesh: insights from genomic analysis
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Evolution of pneumococcal serotype 19A in children in Bangladesh: insights from genomic analysis
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Journal Article
Evolution of pneumococcal serotype 19A in children in Bangladesh: insights from genomic analysis
2025
Overview
Background
Invasive pneumococcal disease (IPD), caused by
Streptococcus pneumoniae
, remains a major global health concern, particularly for children. Among more than 100 pneumococcal serotypes, 19A is known for its multidrug resistance (MDR) and increased incidence following PCV7/PCV10 introduction in many countries. Bangladesh introduced PCV10 in 2015 considering the low burden of 19A in the country.
Methods
Utilizing our IPD surveillance from 2004 to 2023, we investigated the hospital incidence of serotype 19A before and after PCV10 introduction among < 5 years old children in Bangladesh. Whole-genome sequencing was done for 153 serotype 19A isolates from IPD, otitis media, carriage, and urine samples. We used phylogenetic and BEAST analyses to investigate population structure, circulating subtypes, global pneumococcal sequence clusters (GPSCs), sequence types (STs), and antimicrobial resistance genes, and compared them with global 19A genomes.
Results
Our findings indicate no increase in hospital IPD incidence due to serotype 19A following PCV10 introduction. The MDR 19A-ST320 lineage (GPSC1) remains absent in Bangladesh. ST12888 (GPSC84) became dominant in the post-PCV10 introduction (from 15% to 70%). GPSC84 carries the capsular locus of 19A subtype-I (19A-I), which emerged independently from the standard 19A locus. Macrolide resistance is increasing within the 19A-I/GPSC84 lineage and is estimated to have originated between 2007 and 2011.
Conclusions
This study presents the first comprehensive genomic analysis of the serotype 19A population in Bangladesh, supporting the decision to introduce PCV10 in Bangladesh based on local pneumococcal serotype burden data. However, the rapid evolution within the local 19A population highlights the need for continuous epidemiological and genomic surveillance to support effective vaccination programs.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Anti-Bacterial Agents - pharmacology
/ Biomedical and Life Sciences
/ Communicable diseases in children
/ Drug resistance in microorganisms
/ Drug Resistance, Multiple, Bacterial - genetics
/ Female
/ Genes
/ Genomes
/ Genomics
/ Humans
/ Identification and classification
/ Infant
/ Invasive pneumococcal disease
/ Male
/ Mycology
/ PCV10
/ Pneumococcal Infections - epidemiology
/ Pneumococcal Infections - microbiology
/ Pneumococcal Infections - prevention & control
/ Pneumococcal Vaccines - administration & dosage
/ Streptococcus pneumoniae - classification
/ Streptococcus pneumoniae - drug effects
/ Streptococcus pneumoniae - genetics
/ Streptococcus pneumoniae - isolation & purification
/ Virology
