Emergence of Streptococcus pneumoniae serogroups 15 and 35 in nasopharyngeal cultures from young children with acute otitis media.
Emergence of Streptococcus pneumoniae serogroups 15 and 35 in nasopharyngeal cultures from young children with acute otitis media.
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DOI：
10.1097/inf.0000000000000445
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发表时间：
2014-11
期刊：
影响因子：
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通讯作者：
Green M
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作者：
Martin JM;Hoberman A;Paradise JL;Barbadora KA;Shaikh N;Bhatnagar S;Shope T;Block SL;Haralam MA;Kurs-Lasky M;Colborn DK;Green M
在引入7价肺炎球菌结合疫苗（PCV7）之前、期间和之后，对急性中耳炎（AOM）儿童鼻咽部肺炎链球菌定植的监测表明，PCV7菌株几乎完全消除，肺炎球菌血清型19A出现。为了确定引入13价肺炎球菌结合疫苗（PCV 13）对肺炎球菌鼻咽定殖的影响，我们从2012年和2013年期间新发AOM的228名6至23个月的儿童中获得鼻咽培养物，并参加了正在进行的抗菌有效性临床试验。所有儿童均接受了至少2剂PCV 13。色葡萄对肺炎分离株进行血清分型和抗微生物敏感性测试。我们将这些发现与三项早期研究的结果进行了比较。我们发现鼻咽部有S. 113例（50%）AOM患儿中检出肺炎支原体。PCV 7和PCV 13血清型分别占肺炎球菌分离株的2%和12%。在14株PCV 13分离株中，8株为血清型19A。非疫苗血清型占分离株的69%。最常见的是血清型15（23%）和血清型35B（9%）的亚型。总体而言，33%的分离株是青霉素不敏感的，这一比例与我们早期三项研究中发现的比例（分别为26%、36%和37%）没有显著差异。血清型15和35B占青霉素不敏感菌株的51%。扩大儿童肺炎球菌疫苗接种量后，鼻咽部肺炎球菌定植发生了不完全可预测的变化。需要继续监测，以帮助为未来的疫苗开发提供信息。
Surveillance of children with acute otitis media (AOM) for nasopharyngeal colonization with Streptococcus pneumoniae before, during, and after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) indicated the near-complete elimination of PCV7 strains and the emergence of pneumococcal serotype 19A. To determine effects of the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal nasopharyngeal colonization, we obtained nasopharyngeal cultures from 228 children 6 through 23 of age months presenting with a new episode of AOM during 2012 and 2013 and enrolled in an ongoing clinical trial of antimicrobial efficacy. All children had received at least 2 doses of PCV13. The S. pneumoniae isolates were subjected to serotyping and testing for antimicrobial susceptibility. We compared the findings with results obtained in three earlier studies. We found nasopharyngeal colonization with S. pneumoniae in 113 (50%) of the children with AOM. PCV7 and PCV13 serotypes accounted for 2% and 12%, respectively of the pneumococcal isolates. Of the 14 PCV13 isolates, 8 were serotype 19A. Nonvaccine serotypes accounted for 69% of the isolates. Most frequently occurring were subtypes of serotype 15 (23%) and serotype 35B (9%). Overall, 33% of the isolates were penicillin-nonsusceptible, a proportion not significantly different from proportions found in our three earlier studies (26%, 36%, and 37%, respectively). Serotypes 15 and 35B accounted for 51% of penicillin-nonsusceptible isolates. Expansion of contents of pneumococcal vaccine administered to children is followed by not-fully-predictable changes in nasopharyngeal pneumococcal colonization. Continued surveillance is required to help inform future vaccine development.