Emerging non-PCV13 serotypes of noninvasive Streptococcus pneumoniae with macrolide resistance genes in northern Japan.
Emerging non-PCV13 serotypes of noninvasive Streptococcus pneumoniae with macrolide resistance genes in northern Japan.
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DOI：
10.1016/j.nmni.2015.11.001
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发表时间：
2016-01
影响因子：
4
通讯作者：
Kobayashi N
中科院分区：
文献类型：
--
作者：
Kawaguchiya M;Urushibara N;Aung MS;Morimoto S;Ito M;Kudo K;Sumi A;Kobayashi N
日本于 2013 年 4 月将 7 价肺炎球菌结合疫苗（PCV7）纳入国家常规免疫计划，并于 2013 年 11 月被 13 价肺炎球菌结合疫苗（PCV13）取代。共调查了 1097 名（儿童 975 名、儿童 122 名）的血清型和大环内酯类耐药基因型分布。 北海道（日本北部主岛）PCV7 和 PCV13 常规免疫期间（分别为 2013 年 4 月至 10 月和 2013 年 11 月至 2014 年 11 月）从北海道（日本北部主岛）非侵入性感染中分离出 960 株肺炎链球菌（873 名儿童，87 名成人）临床分离株。通过连续多重 PCR 和额外的遗传分析确定血清型。采用多重PCR检测大环内酯类耐药基因erm(B)和mef(A/E)。虽然PCV7时期儿童中最流行的血清型是23A和6C，但在PCV13替代后，19A成为最常见的血清型，其次是6C、15A和23A。在成人中，血清型 3 在整个研究期间始终是最常见的。与PCV7常规免疫前的数据相比，PCV13时期儿童中PCV7血清型的比例从48.3%下降至3.3%，而非PCV13血清型（特别是15A、23A、11A、10A和35B）的比例从39.7%上升至75.1%（p < 0.001）。在 PCV13 时期，erm(B)、mef(A/E) 和这两个基因分别在所有分离株的 75.8%、31.6% 和 11.3% 中检测到。血清型19A占同时具有大环内酯类抗性基因的分离株的76.9%，新出现的非PCV13血清型15A、15C和23A大多携带erm(B)。
In Japan, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced to the nation's routine immunization program in April 2013 and was replaced by the 13-valent pneumococcal conjugate vaccine (PCV13) in November 2013. Distribution of serotypes and macrolide resistance genotypes was investigated for a total of 1097 (975 children, 122 adults) and 960 (873 children, 87 adults) clinical isolates of Streptococcus pneumoniae from noninvasive infections in Hokkaido (northern main island of Japan) in the routine immunization periods for PCV7 and PCV13 (April–October 2013 and November 2013–November 2014, respectively). Serotype was determined by sequential multiplex PCR and additional genetic analyses. Macrolide resistance genes erm(B) and mef(A/E) were detected by multiplex PCR. Although the most prevalent serotypes in children were 23A and 6C in the PCV7 period, after replacement with PCV13, 19A became the most common, followed by 6C, 15A and 23A. Among adults, serotype 3 was consistently the most frequent throughout the study periods. Compared with values from the pre-PCV7 routine immunization period, PCV7 serotypes decreased from 48.3 to 3.3% in the PCV13 period among children, while the rates of non-PCV13 serotypes (particularly 15A, 23A, 11A, 10A and 35B) increased from 39.7 to 75.1% (p < 0.001). In the PCV13 period, erm(B), mef(A/E) and both of these genes were detected in 75.8, 31.6 and 11.3% of all isolates, respectively. Serotype 19A accounted for 76.9% of the isolates with both the macrolide resistance genes, and emerging non-PCV13 serotypes 15A, 15C and 23A mostly harboured erm(B).