Epidemiology of penicillin-non-susceptible pneumococci in Iceland, 19952010
Epidemiology of penicillin-non-susceptible pneumococci in Iceland, 19952010
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DOI：
10.1093/jac/dkt470
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发表时间：
2014-04-01
影响因子：
5.2
通讯作者：
Kristinsson, K. G.
中科院分区：
文献类型：
--
作者：
Hjalmarsdottir, M. A.;Kristinsson, K. G.
1988年在冰岛发现了第一种青霉素不敏感肺炎球菌(PNSP)。随之而来的是随着一个多抗克隆--西班牙(6B)-2的扩大而迅速增加，1993年达到19.8的峰值。在干预措施导致儿童减少使用抗菌剂后，PNSP的流行率一直下降到1995年。这项研究的目的是跟踪1995年至2010年PNSP的演变情况，这是在将结合肺炎球菌疫苗引入疫苗接种计划之前的一段时间。Landspitali大学医院的实验室为冰岛85%的人口提供服务。所有从1995年到2010年分离的肺炎球菌(N13937)都被储存在80C。对苯唑西林耐药株进行血清学分型，并测定青霉素最低抑菌浓度。对筛选出的菌株进行PFGE和多位点基因分型，1995年PNSP率为24.2%，2001年下降到13.6%，2010年上升到38.6%。红霉素和四环素的耐药性也发生了类似的变化。1995年60.7例PNSP为6B型，主要为西班牙(6B)-2克隆，2010年下降至5.7例。血清型19F的PNSP在2004年后迅速增加，在2010年占所有血清型PNSP的85.8%，大多数分离物属于单个多耐药PFGE克隆，分别代表国际克隆台湾(19F)-14的单和双位点变异。PNSP在幼儿中最常见，发生在鼻咽、中耳和下呼吸道。PNSP的流行病学以两个多重耐药克隆为主。当第一种病毒消失时，第二种病毒迅速扩大，导致肺炎球菌对抗生素的耐药率比冰岛以前看到的更高。
The first penicillin-non-susceptible pneumococci (PNSP) were identified in Iceland in 1988. A rapid increase followed, associated with expansion of a single multiresistant clone, Spain(6B)-2, peaking at 19.8 in 1993. After interventions led to reduced antimicrobial use in children, the prevalence of PNSP decreased until 1995. The aim of this study was to follow the evolution of PNSP from 1995 to 2010, the period preceding the introduction of conjugated pneumococcal vaccines into the vaccination programme.The laboratory at the Landspitali University Hospital serves 85 of the Icelandic population. All pneumococci isolated from 1995 to 2010 (n13937) were stored (80C). Oxacillin-resistant isolates were serotyped and penicillin MICs were determined. Selected strains were genotyped by PFGE and multilocus sequence typing.In 1995, the rate of PNSP was 24.2, declining to 13.6 in 2001, and then increasing to 38.6 in 2010. Similar changes were observed for resistance to erythromycin and tetracycline. In 1995, 60.7 of PNSP were serotype 6B, mainly the Spain(6B)-2 clone, declining to 5.7 in 2010. PNSP of serotype 19F rapidly increased after 2004 to comprise 85.8 of all serogrouped PNSP in 2010, with most isolates belonging to a single multiresistant PFGE clone identified as sequence type (ST) 271 and ST1968, representing single- and double-locus variants of the international clone Taiwan(19F)-14, respectively. PNSP were most common among young children, from the nasopharynx, middle ear and lower respiratory tract.The epidemiology of PNSP was dominated by two multiresistant clones. The second expanded rapidly when the first one was disappearing, causing higher antibiotic resistance rates among pneumococci than seen before in Iceland.