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Infection and Immunity, January 2005, p. 431-435, Vol. 73, No. 1
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.1.431-435.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Invasiveness of Serotypes and Clones of Streptococcus pneumoniae among Children in Finland

William P. Hanage,1* Tarja H. Kaijalainen,2 Ritva K. Syrjänen,3 Kari Auranen,3 Maija Leinonen,2 P. Helena Mäkelä,3 and Brian G. Spratt1

Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, St. Mary's Hospital, London, United Kingdom,1 National Reference Laboratory for Pneumococcus, Department of Microbiology, National Public Health Institute, Oulu,2 Department of Vaccines, National Public Health Institute (KTL), Helsinki, Finland3

Received 13 July 2004/ Returned for modification 9 September 2004/ Accepted 16 September 2004

Streptococcus pneumoniae (the pneumococcus) causes diseases from otitis media to life-threatening invasive infection. The species is extremely antigenically and clonally diverse. We wished to determine odds ratios (ORs) for serotypes and clones of S. pneumoniae that cause invasive disease in Finland. A total of 224 isolates of S. pneumoniae from cases of invasive disease in children <2 years of age in Finland between 1995 and 1999 were serotyped, and sequence types (STs) were determined by multilocus sequence typing. These STs were compared with a previously published carriage data set. STs from invasive disease were significantly less diverse than those from carriage (invasive disease, 0.038 ± 0.01; carriage, 0.019 ± 0.005). The ORs of serotypes 14, 18C, 19A, and 6B were significantly greater than 1, indicating association with invasive disease. The ORs of 6A and 11A were significantly less than 1. The difference between 6A and 6B is significant, which suggests that relatively subtle changes in the capsule may have a dramatic effect upon disease potential. We found that ST 156, the Spain9V-3 clone which mainly expressed serotype 14 in Finland, is strongly associated with invasive disease (OR, 10.1; 95% confidence interval, 1.3 to 79.5). Significant associations with invasive disease were also detected for STs 482, 191, 124, and 138, and associations with carriage were detected for STs 485 and 62. These results demonstrate the invasive phenotype of the serotype 14 variant of the Spain9V-3 clone and differences between members of the same serogroup in invasive disease potential.

* Corresponding author. Mailing address: Department of Infectious Disease Epidemiology, Old Medical School Building, St. Mary's Hospital, Imperial College London, London W2 1PG, United Kingdom. Phone: 44 20 7594 3622. Fax: 44 20 7594 3693. E-mail: w.hanage{at}imperial.ac.uk.

Editor: J. N. Weiser

Infection and Immunity, January 2005, p. 431-435, Vol. 73, No. 1
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.1.431-435.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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