Serotype Distribution and Antimicrobial Resistance of Invasive and Noninvasive Streptococcus pneumoniae Isolates in Korea between 2014 and 2016
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Background: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. Methods: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. Results: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more seccommon in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. Conclusions: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Abstract
Background: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. Methods: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. Results: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more seccommon in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. Conclusions: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
참고문헌 (25)
- Kalin M, "Prospective study of prognostic factors in community-acquired bacteremic pneumococcal disease in 5 countries", J Infect Dis, 182, pp.840~847 (2000)
- O’Brien KL, "Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years : global estimates", Lancet, 374, pp.893~902 (2009)
- Walker CLF, "Global burden of childhood pneumonia and diarrhoea", Lancet, 381, pp.1405~1416 (2013)
- Kim SH, "Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries : an Asian Network for Surveillance of Resistant Pathogens(ANSORP)study", Antimicrob Agents Chemother, 56, pp.1418~1426 (2012)
- Konradsen HB, "Invasive pneumococcal infections in Denmark from 1995 to 1999 : epidemiology, serotypes, and resistance", Clin Diagn Lab Immunol, 9, pp.358~365 (2002)
- Whitney CG, "Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine", N Engl J Med, 348, pp.1737~1746 (2003)
- Kaplan SL, "Early trends for invasive pneumococcal infections in children after the introduction of the 13-valent pneumococcal conjugate vaccine", Pediatr Infect Dis J, 32, pp.203~207 (2013)
- Moore MR, "Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005", J Infect Dis, 197, pp.1016~1027 (2008)
- Centers for Disease Control and Prevention (CDC), "Direct and indirect effects of routine vaccination of children with 7-valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease-United States, 1998-2003", MMWR Morb Mortal Wkly Rep, 54, pp.893~897 (2005)
- Hsu HE, "Effect of pneumococcal conjugate vaccine on pneumococcal meningitis", N Engl J Med, 360, pp.244~256 (2009)
- Choi EH, "Streptococcus pneumoniae serotype 19A in children, South Korea", Emerg Infect Dis, 14, pp.275~281 (2008)
- Miller E, "Herd immunity and serotype replacement 4 years after seven-valent pneumococcal conjugate vaccination in England and Wales : an observational cohort study", Lancet Infect Dis, 11, pp.760~768 (2011)
- Lepoutre A, "Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001-2012", Vaccine, 33, pp.359~366 (2015)
- Klugman KP, "Pneumococcal resistance to antibiotics", Clin Microbiol Rev, 3, pp.171~196 (1990)
- Jacobs MR, "Emergence of multiply resistant pneumococci", N Engl J Med, 299, pp.735~740 (1978)
- Kim SH, "Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates causing invasive and noninvasive pneumococcal diseases in Korea from 2008 to 2014", Biomed Res Int, 2016, pp.6950482~ (2016)
- 김시현, "부산 및 경남 4개 대학병원에서 분리된 폐렴알균의 분포 및 항균제 내성", Annals of Clinical Microbiology, 19(2), pp.48~53 (2016), 대한임상미생물학회
- CLSI, "Performance standards for antimicrobial susceptibility testing. 18th ed. Informational supplement M100-S18", Clinical and Laboratory Standards Institute, ~ (2008)
- Brito DA, "Serotyping Streptococcus pneumoniae by multiplex PCR", J Clin Microbiol, 41, pp.2378~2384 (2003)
- CLSI, "Performance standards for antimicrobial susceptibility testing M100, 27th ed", Clinical and Laboratory Standards Institute, ~ (2017)
- 최원석, "Revised Adult Immunization Guideline Recommended by the Korean Society of Infectious Diseases, 2014", Infection and Chemotherapy, 47(1), pp.68~79 (2015), 대한감염학회
- Richter SS, "Changes in pneumococcal serotypes and antimicrobial resistance after introduction of the 13-valent conjugate vaccine in the United States", Antimicrob Agents Chemother, 58, pp.6484~6489 (2014)
- Richter SS, "Evaluation of pneumococcal serotyping by multiplex PCR and quellung reactions", J Clin Microbiol, 51, pp.4193~4195 (2013)
- Galanis I, "Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden", Eur Respir J, 47, pp.1208~1218 (2016)
- van der Linden M, "Increase of serotypes 15A and 23B in IPD in Germany in the PCV13 vaccination era", BMC Infect Dis, 15, pp.207~ (2015)