Serotype 6C is associated with penicillin-susceptible meningeal infections in human immunodeficiency virus (HIV)-infected adults among invasive pneumococcal isolates previously identified as serotype 6A in South Africa
Serotype 6C is associated with penicillin-susceptible meningeal infections in human immunodeficiency virus (HIV)-infected adults among invasive pneumococcal isolates previously identified as serotype 6A in South Africa
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DOI：
10.1016/j.ijantimicag.2008.06.002
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发表时间：
2008-11-01
影响因子：
10.8
通讯作者：
Klugman, Keith P.
中科院分区：
文献类型：
--
作者：
du Plessis, Mignon;von Gottberg, Anne;Klugman, Keith P.
当使用传统的Quellung血清分型方法时，新描述的肺炎球菌血清型（6C）与血清型6A无法区分。采用聚合酶链反应（PCR）对荚膜位点的wciN区进行血清型6A分离株筛选。本研究在南非国家实验室监测（2005-2006年）的侵袭性肺炎球菌病（IPD）分离株中检测到血清6C型。1998-2005年参加9价肺炎球菌结合疫苗试验的23例儿童血清6A病例中未发现血清6C分离株。在全国报告的8167例IPD病例中，87%的病例（n = 7080）有活的分离株可用于血清分型。Quellung血清分型鉴定出608株血清6A型分离株，其中606株进一步检测血清6C型。经PCR检测，5%（30/606）的分离株血清型为6C。血清型6C分离株在儿童中引起疾病的可能性低于成人(6/30 (20%)vs 311/550 (57%))；P < 0.001)；更有可能引起实验室确诊的脑膜炎(15/30 (50%)vs. 167/578 (29%)；P = 0.01)；更有可能表现出对青霉素的敏感性（0/30对129/578 (22%)）；P = 0.004)。与性别、人类免疫缺陷病毒（HIV）合并感染或病死率无关联。虽然血清6C型患病率较低，但其流行病学可能与其他血清6型肺炎球菌不同。我们的疫苗功效试验数据表明，结合疫苗的交叉保护是针对真正的血清型6A菌株。(c) 2008 Elsevier B.V.和国际化学疗法学会。版权所有。
A newly described pneumococcal serotype (6C) is indistinguishable from serotype 6A when using the conventional Quellung serotyping method. Serotype 6A isolates were screened by polymerase chain reaction (PCR) for the wciN region of the capsular locus. This study detected serotype 6C among invasive pneumococcal disease (IPD) isolates from national laboratory-based surveillance (2005-2006) in South Africa. No serotype 6C isolates were identified among 23 serotype 6A cases from children enrolled in a 9-valent pneumococcal conjugate vaccine trial (1998-2005). Of 8167 IPD cases reported nationally, viable isolates were available for serotyping in 87% of cases (n = 7080). Quellung serotyping identified 608 serotype 6A isolates, of which 606 were further tested for serotype 6C. PCR confirmed serotype 6C in 5% (30/606) of the isolates tested. Serotype 6C isolates were: less likely than 6A to cause disease in children compared with adults (6/30 (20%) vs. 311/550 (57%); P < 0.001); more likely to cause laboratory-confirmed meningitis (15/30 (50%) vs. 167/578 (29%); P = 0.01); and more likely to demonstrate susceptibility to penicillin (non-susceptibility 0/30 vs. 129/578 (22%); P = 0.004). No association with gender, human immunodeficiency virus (HIV) co-infection or case fatality rate was observed. Although serotype 6C prevalence was low, its epidemiology may differ from the other serogroup 6 pneumococci. Our data from the vaccine efficacy trial suggest that cross-protection of the conjugate vaccine is against true serotype 6A strains. (c) 2008 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.