A decade-long surveillance of nasopharyngeal colonisation with Streptococcus pneumoniae among children attending day-care centres in south-eastern France: 1999-2008
A decade-long surveillance of nasopharyngeal colonisation with Streptococcus pneumoniae among children attending day-care centres in south-eastern France: 1999-2008
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DOI：
10.1007/s10096-011-1154-9
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发表时间：
2011-07-01
影响因子：
4.5
通讯作者：
Pradier, C.
中科院分区：
文献类型：
--
作者：
Dunais, B.;Bruno-Bazureault, P.;Pradier, C.
从1999年到2008年，在2000年开始的促进谨慎使用抗生素的干预措施和2003年肺炎球菌结合疫苗的可用性之前和之后，对法国东南部日托中心儿童中肺炎链球菌（SP）的耐药性和血清型分布进行了监测。1999年、2002年、2004年、2006年和2008年1月至3月，对3-40个月日托中心儿童鼻咽样本进行了SP分离株的抗生素敏感性和血清型测定。SP携带率从54%下降到45%，对青霉素敏感性降低的SP（PDSP）从34%下降到19%。抗生素处方从63%下降到38%，但第三代头孢菌素的处方越来越多。总体抗生素敏感性增加。2008年，90%以上的儿童至少接种了一剂疫苗。1999年的疫苗血清型6 B、9 V、19 F和23 F（76%）在2008年被非疫苗血清型（95%）取代，其中15（20%）、19 A（15%）、23 A/B（10%）和6 A（9%）。血清型6A、19 A和15在2008年占PDSP菌株的50%以上，而1999年为6%。现在的儿童大多数是非疫苗类型;然而，PDSP分离株主要是在这些类型中招募的。与疫苗相关的益处可能受到疫苗和疫苗联合驱动的选择性压力的威胁。
The antimicrobial resistance and serotype distribution of Streptococcus pneumoniae (SP) among children attending day-care centres in south-eastern France were monitored from 1999 to 2008, before and after interventions promoting prudent antibiotic use initiated in 2000 and the availability of pneumococcal conjugate vaccine in 2003. Antibiotic susceptibility and serotypes of SP isolates were determined on nasopharyngeal samples of children aged 3-40 months attending day-care centres, from January to March 1999, 2002, 2004, 2006 and 2008. SP carriage fell from 54% to 45%, and SP with diminished susceptibility to penicillin (PDSP) fell from 34% to 19%. Antibiotic prescriptions dropped from 63% to 38% of children, but third-generation cephalosporins were increasingly prescribed. The overall antibiotic susceptibility increased. Over 90% of the children had received at least one vaccine dose in 2008. Vaccine serotypes 6B, 9V, 19F and 23F (76%) in 1999 were replaced by non-vaccine types (95%) in 2008, among which were 15 (20%), 19A (15%), 23A/B (10%) and 6A (9%). Serotypes 6A, 19A and 15 accounted for over 50% of PDSP strains in 2008 versus 6% in 1999. Children now mostly harbour non-vaccine types; however, PDSP isolates are mainly recruited among these. Vaccine-related benefits may be threatened by combined vaccine- and antibiotic-driven selective pressure.