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Invasive disease potential for pneumococcal serotypes were calculated using 165 invasive and 550 carriage isolates from children.<\/jats:p><jats:p>The invasive disease potential was lower for non-PCV13 compared to vaccine-type strains. Patients infected with non-PCV13 strains had more underlying diseases, were less likely to have pneumonia and, in adults, tended to have a higher mortality. Furthermore, patients infected with pneumococci belonging to clonal serotypes only expressing non-PCV13 capsules had a higher risk for septicaemia and mortality.<\/jats:p><jats:p>PCV vaccination will probably lead to a decrease in invasive pneumococcal disease but an alteration in the clinical manifestation of invasive pneumococcal disease. Genetic lineages causing invasive pneumococcal disease in adults often express non-vaccine serotypes, which can expand after vaccination with an increased risk of infection in patients with underlying diseases.<\/jats:p>","DOI":"10.1183\/09031936.00080814","type":"journal-article","created":{"date-parts":[[2014,10,17]],"date-time":"2014-10-17T10:08:52Z","timestamp":1413540532000},"page":"1646-1657","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":46,"title":["Clinical manifestations of invasive pneumococcal disease by vaccine and non-vaccine 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