PT  - JOURNAL ARTICLE
AU  - Uri Obolski
AU  - José Lourenço
AU  - Sunetra Gupta
TI  - Vaccination can drive an increase in frequencies of antibiotic resistance among non-vaccine serotypes of <em>Streptococcus pneumoniae</em>
AID  - 10.1101/135863
DP  - 2017 Jan 01
TA  - bioRxiv
PG  - 135863
4099  - http://biorxiv.org/content/early/2017/05/09/135863.short
4100  - http://biorxiv.org/content/early/2017/05/09/135863.full
AB  - The bacterial pathogen Streptococcus pneumoniae is a major public health concern, being responsible for more than 1.5 million deaths annually through pneumonia, meningitis and septicemia. In spite of vaccination efforts, pneumococcal carriage and disease remain high, since available vaccines target only a subset of serotypes and vaccination is often accompanied by a rise in non-vaccine serotypes. Epidemiological studies suggest that such a change in serotype frequencies is often coupled with an increase of antibiotic resistance among non-vaccine serotypes. Building on previous multi-locus models for bacterial pathogen population structure, we have developed a theoretical framework incorporating variation in serotype and antibiotic resistance to examine how their associations may be affected by vaccination. Using this framework, we find that vaccination can result in rapid increase in frequency of pre-existing resistant variants of non-vaccine serotypes due to the removal of competition from vaccine serotypes.