{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:58:46Z","timestamp":1781272726354,"version":"3.54.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"2","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive pneumococcal disease (IPD) isolates forming genomic clusters can reflect rapid disease transmission between vulnerable individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed whole genome sequencing of 2820 IPD isolates recovered during 2019 through Centers for Disease Control and Prevention\u2019s Active Bacterial Core surveillance to provide strain information (serotypes, resistance, genotypes), and 2778 of these genomes were analyzed to detect highly related genomic clusters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Isolates from persons experiencing homelessness (PEH) were more often within genomic clusters than those from persons not experiencing homelessness (PNEH) (105\/198 [53.0%] vs 592\/2551 [23.2%]; P\u2005&amp;lt;\u2005.001). The 4 western sites accounted for 33.4% (929\/2778) of isolates subjected to cluster analysis yet accounted for 48.7% (343\/705) of clustering isolates (P\u2005&amp;lt;\u2005.001) and 75.8% (150\/198) of isolates recovered from PEH (P\u2005&amp;lt;\u2005.001). Serotypes most frequent among PEH were (in rank order) 12F, 4, 3, 9N, 8, 20, and 22F, all of which were among the 10 serotypes exhibiting the highest proportions of clustering isolates among all cases. These serotypes accounted for 44.9% (1265\/2820) of all IPD cases and are included within available vaccines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We identified serotype-specific and geographic differences in IPD transmission. We show the vulnerability of PEH within different regions to rapidly spreading IPD transmission networks representing several pneumococcal serotypes included in available vaccines.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiac058","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T20:12:18Z","timestamp":1644869538000},"page":"332-341","source":"Crossref","is-referenced-by-count":10,"title":["Invasive Pneumococcal Disease Clusters Disproportionally Impact Persons Experiencing Homelessness, Injecting Drug Users, and the Western United States"],"prefix":"10.1093","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5315-1070","authenticated-orcid":false,"given":"Bernard","family":"Beall","sequence":"first","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention (retired) , Atlanta, Georgia , USA"},{"name":"Eagle Global Scientific, LLC , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8222-7353","authenticated-orcid":false,"given":"Sopio","family":"Chochua","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongya","family":"Li","sequence":"additional","affiliation":[{"name":"IHRC Inc , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Tran","sequence":"additional","affiliation":[{"name":"IHRC Inc , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Varghese","sequence":"additional","affiliation":[{"name":"IHRC Inc , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"McGee","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J","family":"Metcalf","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"2022082412282546300_CIT0001","first-page":"1627","article-title":"Twenty years of active bacterial core surveillance.","volume":"27","author":"Langley","year":"2021","journal-title":"Emerg Infect Dis"},{"key":"2022082412282546300_CIT0002","author":"Centers for Disease Control and Prevention."},{"key":"2022082412282546300_CIT0003","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1086\/648593","article-title":"Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine.","volume":"201","author":"Pilishvili","year":"2010","journal-title":"J Infect Dis"},{"key":"2022082412282546300_CIT0004","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S1473-3099(14)71081-3","article-title":"Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance.","volume":"15","author":"Moore","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"2022082412282546300_CIT0005","doi-asserted-by":"crossref","first-page":"5428","DOI":"10.1016\/j.vaccine.2021.07.004","article-title":"A phase 3, randomized, double-blind study to evaluate the immunogenicity and safety of 3 lots of 20-valent pneumococcal conjugate vaccine in pneumococcal vaccine-naive adults 18 through 49 years of age.","volume":"39","author":"Klein","year":"2021","journal-title":"Vaccine"},{"key":"2022082412282546300_CIT0006","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.vaccine.2021.08.049","article-title":"A phase 3 trial of safety, tolerability, and immunogenicity of V114, 15-valent pneumococcal conjugate vaccine, compared with 13-valent pneumococcal conjugate vaccine in adults 50 years of age and older (PNEU-AGE).","volume":"40","author":"Platt","year":"2022","journal-title":"Vaccine"},{"key":"2022082412282546300_CIT0007","doi-asserted-by":"crossref","first-page":"109","DOI":"10.15585\/mmwr.mm7104a1","article-title":"Use of 15-valent pneumococcal conjugate vaccine and 20-valent pneumococcal conjugate vaccine among U.S. adults: updated recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2022.","volume":"71","author":"Kobayashi","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022082412282546300_CIT0008","doi-asserted-by":"crossref","first-page":"2670","DOI":"10.3389\/fmicb.2018.02670","article-title":"A population-based descriptive atlas of invasive pneumococcal strains recovered within the U.S. during 2015-2016.","volume":"9","author":"Beall","year":"2018","journal-title":"Front Microbiol"},{"key":"2022082412282546300_CIT0009","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1038\/s41467-018-07997-y","article-title":"Genome-wide association analyses of invasive pneumococcal isolates identify a missense bacterial mutation associated with meningitis.","volume":"10","author":"Li","year":"2019","journal-title":"Nat Commun"},{"key":"2022082412282546300_CIT0010","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1093\/infdis\/jiaa501","article-title":"Upsurge of conjugate vaccine serotype 4 invasive pneumococcal disease clusters among adults experiencing homelessness in California, Colorado, and New Mexico.","volume":"223","author":"Beall","year":"2021","journal-title":"J Infect Dis"},{"key":"2022082412282546300_CIT0011","doi-asserted-by":"crossref","first-page":"e948","DOI":"10.1093\/cid\/ciaa1680","article-title":"Invasive pneumococcal strain distributions and isolate clusters associated with persons experiencing homelessness during 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