Phylogenetic Analysis of Invasive Serotype 1 Pneumococcus in South Africa, 1989 to 2013.
Phylogenetic Analysis of Invasive Serotype 1 Pneumococcus in South Africa, 1989 to 2013.
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DOI：
10.1128/jcm.00055-16
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发表时间：
2016-05
影响因子：
9.4
通讯作者：
von Gottberg A
中科院分区：
文献类型：
--
作者：
du Plessis M;Allam M;Tempia S;Wolter N;de Gouveia L;von Mollendorf C;Jolley KA;Mbelle N;Wadula J;Cornick JE;Everett DB;McGee L;Breiman RF;Gladstone RA;Bentley SD;Klugman KP;von Gottberg A
血清型1是南非侵袭性肺炎球菌病的一个重要病因，在2011年引入13价肺炎球菌结合疫苗后，发病率有所下降。我们对1989年至2013年912株侵袭性血清1型分离株进行了遗传鉴定。计算Simpson多样性指数(D)和重组比。评估与序列类型（STs）相关的因素。克隆复合体217占96%（872/912）。引入13价肺炎球菌结合疫苗（PCV13）后，ST多样性在<5岁儿童（D, 0.39 ~ 0.63, P = 0.002）和>4岁个体（D, 0.35 ~ 0.54, P < 0.001）中增加：ST-217在<5岁儿童（153/203[75%]比21/37 [57%]，P = 0.027）和>14岁个体（242/305[79%]比96/148 [65%]，P = 0.001）中成比例下降，而ST-9067增加（4/684[0.6%]比24/228 [11%]，P < 0.001）。在ST-217中鉴定出3个亚支：ST-217C1（353/382[92%]）、ST-217C2（15/382[4%]）和ST-217C3（14/382[4%]）。ST-217C2、ST-217C3和单位点变异（SLV） ST-8314（20/912[2%]）与氯霉素、四环素和复方新诺明不敏感相关。ST-8314（20/912[2%]）也与青霉素不敏感性增加相关（P < 0.001）。ST-217C3和新报道的ST-9067的重组率高于ST-217C1（分别为4.344比0.091,P < 0.001； 0.086比0.013,P < 0.001）。pcv13后发现遗传多样性增加，并确定了与抗菌素不敏感性相关的谱系。
Serotype 1 is an important cause of invasive pneumococcal disease in South Africa and has declined following the introduction of the 13-valent pneumococcal conjugate vaccine in 2011. We genetically characterized 912 invasive serotype 1 isolates from 1989 to 2013. Simpson's diversity index (D) and recombination ratios were calculated. Factors associated with sequence types (STs) were assessed. Clonal complex 217 represented 96% (872/912) of the sampled isolates. Following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), ST diversity increased in children <5 years (D, 0.39 to 0.63, P = 0.002) and individuals >14 years (D, 0.35 to 0.54, P < 0.001): ST-217 declined proportionately in children <5 years (153/203 [75%] versus 21/37 [57%], P = 0.027) and individuals >14 years (242/305 [79%] versus 96/148 [65%], P = 0.001), whereas ST-9067 increased (4/684 [0.6%] versus 24/228 [11%], P < 0.001). Three subclades were identified within ST-217: ST-217C1 (353/382 [92%]), ST-217C2 (15/382 [4%]), and ST-217C3 (14/382 [4%]). ST-217C2, ST-217C3, and single-locus variant (SLV) ST-8314 (20/912 [2%]) were associated with nonsusceptibility to chloramphenicol, tetracycline, and co-trimoxazole. ST-8314 (20/912 [2%]) was also associated with increased nonsusceptibility to penicillin (P < 0.001). ST-217C3 and newly reported ST-9067 had higher recombination ratios than those of ST-217C1 (4.344 versus 0.091, P < 0.001; and 0.086 versus 0.013, P < 0.001, respectively). Increases in genetic diversity were noted post-PCV13, and lineages associated with antimicrobial nonsusceptibility were identified.