Syrogiannopoulos George A, Katopodis George D, Grivea Ioanna N, Beratis Nicholas G
Department of Pediatrics, Division of Infectious Disease, University of Patras, School of Medicine, General University Hospital, Patras, Greece.
Clin Infect Dis. 2002 Nov 15;35(10):1174-82. doi: 10.1086/343824. Epub 2002 Oct 21.
The serotype distribution of 781 nasopharyngeal pneumococcal isolates recovered from 2448 unselected children aged 2-23 months was studied. Only 3.9% of the children for whom cultures were performed attended day care centers. The proportions of pneumococcal isolates that belonged to serotypes related to the 7-, 9- and 11-valent conjugate pneumococcal vaccine were 65%, 66%, and 70%, respectively. The pneumococcal carriage rate among untreated children was 34%; the rates among children treated with antibiotics during the periods 1-30 or 31-60 days before the time of nasopharyngeal sampling were 25% and 36%, respectively. There was a significant positive association between antimicrobial use and carriage of antibiotic-resistant pneumococci, which belonged mainly to vaccine-related serotypes. The proportion of isolates that belonged to vaccine-related serotypes in untreated carriers was 72%; however, the proportions in carriers treated 1-30 days or 31-60 days before sampling were 66% and 56%, respectively. In the nasopharynx, antimicrobial use selects for antibiotic-resistant pneumococci, mainly of vaccine-related serotypes, whereas it may promote an increase in the frequency of colonization with nonvaccine serotypes.
对从2448名年龄在2至23个月的未经过筛选的儿童中分离出的781株鼻咽部肺炎球菌菌株的血清型分布情况进行了研究。进行培养的儿童中只有3.9%去过日托中心。属于与7价、9价和11价肺炎球菌结合疫苗相关血清型的肺炎球菌菌株比例分别为65%、66%和70%。未经治疗的儿童中肺炎球菌携带率为34%；在鼻咽采样前1至30天或31至60天期间接受抗生素治疗的儿童中，携带率分别为25%和36%。抗菌药物的使用与主要属于疫苗相关血清型的耐抗生素肺炎球菌的携带之间存在显著的正相关。未经治疗的携带者中属于疫苗相关血清型的菌株比例为72%；然而，在采样前1至30天或31至60天接受治疗的携带者中，这一比例分别为66%和56%。在鼻咽部，抗菌药物的使用会选择出主要为疫苗相关血清型的耐抗生素肺炎球菌，而这可能会促使非疫苗血清型的定植频率增加。
