Epidemiology of serotype 19A isolates from invasive pneumococcal disease in German children

BMC Infectious Diseases

Research Article

Winfried V Kern¹  Mark van der Linden²  Matthias Imöhl²  Ralf René Reinert² 

[1] Division of Infectious Diseases, Department of Medicine, Albert-Ludwigs-University, Freiburg, Germany;Institute for Medical Microbiology, National Reference Center for Streptococci, Department of Medical Microbiology, University Hospital (RWTH), Pauwelsstr. 30, 52074, Aachen, Germany;

关键词: Streptococcus pneumoniae;    Serotype 19A;    Germany;   

DOI  :  10.1186/1471-2334-13-70

 received in 2012-09-25, accepted in 2013-01-31,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThis study presents an analysis of 159 serotype 19A isolates from IPD in children before and after the general recommendation for childhood pneumococcal conjugate vaccination in Germany in July 2006. Vaccination formulations used were PCV7, PCV10 (from April 2009) and PCV13 (from Dec. 2009, replacing PCV7).MethodsIsolates from invasive pneumococcal disease in children were serotyped using the Quellung reaction, tested for antibiotic susceptibility and analysed for their multi locus sequence type.ResultsIn an analysis of 3328 isolates from invasive pneumococcal disease (IPD) in children that were sent to the German National Reference Center for Streptococci between July 1997 and June 2011, we show that the proportion of 19A isolates ranged between 1.7 and 4.2% in the period 1997 to 2006. After the recommendation for pneumococcal conjugate childhood vaccination, which was issued in July 2006, the proportion of 19A isolates increased significantly to 15.0% in 2010/11. Eight clonal complexes (CC) and groups accounted for 77.2% and 65.3% of all serotype 19A isolates before and after vaccination, respectively. While three CCs and several STs were not detected after vaccine introduction, four CCs and several STs first appeared after vaccination, including three ST320 isolates that could be traced to recent imports from the US, UK and India. The proportion of penicillin-nonsusceptible and of multidrug-resistant 19A isolates moderately increased after vaccine introduction. A significant increase in the use of cephalosporins and azithromycin was noted post-vaccination (p=0.00001 and p=0.0013 respectively).ConclusionsThe prevalence of serotype 19A in Germany has increased significantly between July 2007 and June 2011. Possible reasons for this are the introduction of pneumococcal conjugate vaccination, increased use of cephalosporins and azithromycin, import of multidrug-resistant isolates and increased reporting.

【 授权许可】

CC BY   
© van der Linden et al.; licensee BioMed Central Ltd. 2013