The contribution of specific pneumococcal serogroups to different disease manifestations: Implications for conjugate vaccine formulation and use, part II

To assess whether certain serogroups of Streptococcus pneumoniae are prefer entially associated with specific disease manifestations, we analyzed all r ecent pneumococcal disease studies and assessed the relative frequency of i solation of each serogroup by clinical site (as a proxy for different disea se states). In all age groups, serogroups 1 and 14 were more often isolated from blood, and serogroups 6, 10, and 23 were more often isolated from cer ebrospinal fluid (CSF); in young children, serogroups 3, 19, and 23 were mo re often isolated from middle ear fluid (MEF), Serogroups represented in co njugate vaccines were isolated slightly less frequently from CSF than from blood or MEF. Nonetheless, serogroups in the 9-valent conjugate vaccine for mulation still comprised similar to 75% of pneumococcal isolates from the C SF of young children in Europe and in the United States and Canada. These a nalyses indicate that pneumococcal conjugate vaccines could potentially pre vent a substantial proportion of episodes of bacteremic disease, pneumonia, meningitis, and otitis media, especially in young children.