Changing Trends in Antimicrobial Resistance and Serotypes of Streptococcus pneumoniae Isolates in Asian Countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study
Changing Trends in Antimicrobial Resistance and Serotypes of Streptococcus pneumoniae Isolates in Asian Countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study
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DOI：
10.1128/aac.05658-11
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发表时间：
2012-03-01
影响因子：
4.9
通讯作者：
Peck, Kyong Ran
中科院分区：
文献类型：
--
作者：
Kim, So Hyun;Song, Jae-Hoon;Peck, Kyong Ran
尽管引入了七价肺炎球菌结合疫苗（PCV7），但肺炎链球菌的抗菌药物耐药性仍然是世界范围内的一个严重问题，特别是在亚洲国家。亚洲耐药病原体监测网络（ANSORP）对 2008 年至 2009 年从亚洲 11 个国家 60 家医院的肺炎球菌感染患者收集的 2,184 株肺炎链球菌分离株进行了前瞻性监测研究。在非脑膜分离株中，青霉素不敏感肺炎球菌的患病率（MIC，≥ 4 mu） g/ml）为 4.6%，青霉素耐药性（MIC，>= 8 μg/ml）极为罕见（0.7%）。该地区对红霉素的耐药性非常普遍（72.7%）；比例最高的是中国（96.4%）、台湾（84.9%）和越南（80.7%）。在来自亚洲国家的 59.3% 的分离株中观察到多重耐药性 (MDR)。主要血清型为19F（23.5%）、23F（10.0%）、19A（8.2%）、14（7.3%）和6B（7.3%）。总体而言，52.5% 的分离株显示 PCV7 血清型，范围从菲律宾的 16.1% 到越南的 75.1%。血清型 19A (8.2%)、3 (6.2%) 和 6A (4.2%) 是亚洲地区最常见的非 PCV7 血清型。在血清型 19A 的分离株中，分别有 86.0% 和 79.8% 显示出红霉素耐药性和 MDR。 PCV7 引入后，亚洲国家肺炎链球菌流行病学最显着的发现是大环内酯类耐药性和耐多药性的高流行以及血清型 19A 的显着增加。
Antimicrobial resistance in Streptococcus pneumoniae remains a serious concern worldwide, particularly in Asian countries, despite the introduction of heptavalent pneumococcal conjugate vaccine (PCV7). The Asian Network for Surveillance of Resistant Pathogens (ANSORP) performed a prospective surveillance study of 2,184 S. pneumoniae isolates collected from patients with pneumococcal infections from 60 hospitals in 11 Asian countries from 2008 to 2009. Among nonmeningeal isolates, the prevalence rate of penicillin-nonsusceptible pneumococci (MIC, >= 4 mu g/ml) was 4.6% and penicillin resistance (MIC, >= 8 mu g/ml) was extremely rare (0.7%). Resistance to erythromycin was very prevalent in the region (72.7%); the highest rates were in China (96.4%), Taiwan (84.9%), and Vietnam (80.7%). Multidrug resistance (MDR) was observed in 59.3% of isolates from Asian countries. Major serotypes were 19F (23.5%), 23F (10.0%), 19A (8.2%), 14 (7.3%), and 6B (7.3%). Overall, 52.5% of isolates showed PCV7 serotypes, ranging from 16.1% in Philippines to 75.1% in Vietnam. Serotypes 19A (8.2%), 3 (6.2%), and 6A (4.2%) were the most prominent non-PCV7 serotypes in the Asian region. Among isolates with serotype 19A, 86.0% and 79.8% showed erythromycin resistance and MDR, respectively. The most remarkable findings about the epidemiology of S. pneumoniae in Asian countries after the introduction of PCV7 were the high prevalence of macrolide resistance and MDR and distinctive increases in serotype 19A.