Streptococcus pneumonide serogroups 15 and 33 -: An increasing cause of pneumococcal infections in children in the united states after the introduction of the pneumococcal 7-valent conjugate vaccine
Streptococcus pneumonide serogroups 15 and 33 -: An increasing cause of pneumococcal infections in children in the united states after the introduction of the pneumococcal 7-valent conjugate vaccine
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DOI：
10.1097/01.inf.0000207484.52850.38
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发表时间：
2006-04-01
影响因子：
3.6
通讯作者：
Mason, EO
中科院分区：
文献类型：
--
作者：
Gonzalez, BE;Hulten, KG;Mason, EO
背景：在7价肺炎球菌结合疫苗广泛使用后，出现了替代血清型。血清群15和33已成为引起侵袭性疾病的非疫苗血清型。我们描述了这些血清群引起的感染的儿童的临床特征，并确定了菌株的遗传关系。材料和方法：美国儿科多中心肺炎球菌监测组已前瞻性地确定自1993年以来的肺炎球菌感染的儿童。图表进行了回顾性审查，菌株进行血清学和血清分型和随机选择的菌株进行指纹与脉冲场凝胶电泳。选定的菌株进一步特点是多位点序列typing.Results：1994年1月至2004年12月，103名儿童肺炎球菌疾病引起的血清群15，40名儿童感染引起的血清群33。血清群15从接种前的平均每年7例增加到接种后的每年14例，血清群33从每年2例增加到同期的每年7例。在这两个时期，分离株对青霉素和头孢曲松敏感。在每个血清群中发现了占血清群15株的60%（50株中的30株）和血清型33F株的83%（29株中的24株）的优势克隆。血清组15克隆包含血清型15 B和15 C的菌株，而33克隆仅包含血清型33 F菌株。一个分离的15和33个克隆的特点是多位点序列分型，被发现是ST 199和100，分别。结论：在美国，由青霉素敏感的血清群15和33克隆引起的儿童肺炎球菌疾病正在增加。当接种疫苗的儿童出现侵袭性肺炎球菌疾病时，临床医生应考虑更换血清型。
Background: After the widespread use of the 7-valent pneumococcal conjugate vaccine, replacement serotypes have emerged. Serogroups 15 and 33 have emerged as nonvaccine serotypes causing invasive disease. We describe the clinical characteristics of children with infections caused by these serogroups and determined the genetic relationship of the strains.Materials and Methods: The United States Pediatric Multicenter Pneumococcal Surveillance Group has prospectively identified children with pneumococcal infections since 1993. Charts were reviewed retrospectively, isolates were serogrouped and serotyped and randomly selected strains were fingerprinted with the use of pulsed field gel electrophoresis. Selected strains were further characterized by multilocus sequence typing.Results: Between January 1994 and December 2004, 103 children had pneumococcal disease caused by serogroup 15, and 40 children had infections caused by serogroup 33. There was an increase from a mean of 7 cases per year for serogroup 15 in the prevaccine period to 14 cases per year in the postvaccine period and from 2 cases per year for serogroup 33 to 7 cases per year in the same periods. Isolates were susceptible to penicillin and ceftriaxone in both periods. A predominant clone was found in each serogroup representing 60% (30 of 50) of serogroup 15 strains and 83% (24 of 29) of the serotype 33F strains. The serogroup 15 clone comprised strains of serotypes 15B and 15C, whereas the 33 clone contained only serotype 33F strains. One isolate from each of the 15 and 33 clones was characterized by multilocus sequence typing and were found to be ST199 and 100, respectively.Conclusions: Pneumococcal disease in children caused by penicillin-susceptible clones of serogroups 15 and 33 is increasing in the United States. Clinicians should consider replacement serotypes when encountered with invasive pneumococcal disease in vaccinated children.