Characterization of invasive isolates of Streptococcus pneumoniae among Taiwanese children
Characterization of invasive isolates of Streptococcus pneumoniae among Taiwanese children
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DOI：
10.1111/j.1469-0691.2009.02743.x
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发表时间：
2009-11-01
影响因子：
14.2
通讯作者：
Hsueh, P. -R.
中科院分区：
文献类型：
--
作者：
Hsieh, Y. -C.;Huang, Y. -C.;Hsueh, P. -R.
P>准确的分子监测对于监测肺炎链球菌的动态非常重要。一项前瞻性研究从2004年1月至2006年12月在台湾收集了儿童的侵袭性肺炎链球菌分离株进行基因分析。在这些侵入性分离株中，进行 PCR 检测 zmpC 和 zmpD 基因，这两个基因均编码肺炎球菌中的金属蛋白酶毒力因子。研究期间，获得了 68 株侵入性肺炎链球菌分离株进行分析。血清型 14 是从侵袭性疾病儿童中分离出的最常见类型，与肺炎显着相关（OR 3.1；95% CI] 1.1-8.8；p < 0.035）。血清型 23F 与菌血症显着相关（OR 7.5；95% CI 1.8-31.3；p < 0.006）。七价结合疫苗覆盖了 83.8% 的侵袭性分离株，但有基础疾病的患者中分离出非疫苗血清型的频率高于无基础疾病的患者（Fisher 精确检验 p = 0.007）。与国际克隆Spain23F ST81、Spain6B ST95、England14 ST9、Taiwan19F ST236、Taiwan23F ST242和Colombia23F ST338相关的克隆复合体占入侵分离株的52.9%。还发现台湾首次发现的青霉素抗性克隆ST876、ST46、ST76和ST2889的传播； 1.5%的入侵菌株携带zmpC基因，47.1%的入侵菌株携带zmpD基因。总之，某些国际克隆和一些国内抗生素抗性克隆的传播导致了台湾儿童的侵袭性疾病。
P>Accurate molecular surveillance is important in monitoring the dynamics of Streptococcus pneumoniae. A prospective study was conducted to collect invasive isolates of S. pneumoniae from children for genetic analysis from January 2004 to December 2006 in Taiwan. PCRs were performed to detect the zmpC and zmpD genes, both encoding a metalloprotease virulence factor in pneumococci, among these invasive isolates. During the study period, 68 invasive isolates of S. pneumoniae were obtained for analysis. Serotype 14 was the most common type isolated from children with invasive disease and was significantly associated with pneumonia (OR 3.1; 95% CI] 1.1-8.8; p 0.035). Serotype 23F was significantly associated with bacteraemia (OR 7.5; 95% CI 1.8-31.3; p 0.006). The seven-valent conjugate vaccine covered 83.8% of invasive isolates, but non-vaccine serotypes were more frequently isolated from patients with underlying diseases than from patients without underlying diseases (p 0.007 by Fisher's exact test). Clonal complexes related to international clones Spain23F ST81, Spain6B ST95, England14 ST9, Taiwan19F ST236, Taiwan23F ST242 and Colombia23F ST338 accounted for 52.9% of invasive isolates. Dissemination of the penicillin-resistant clones ST876, ST46, ST76 and ST2889, which were first identified in Taiwan, was also found; 1.5% of these invasive isolates carried the zmpC gene, and 47.1% of these invasive isolates carried the zmpD gene. In conclusion, the spread of certain international clones and some domestic antibiotic-resistant clones resulted in invasive diseases among Taiwanese children.