Institute of Medical Microbiology, National Reference Centre for Streptococci, University Hospital (RWTH), Aachen, Germany.
Clin Microbiol Infect. 2009 Nov;15(11):1008-12. doi: 10.1111/j.1469-0691.2009.02895.x. Epub 2009 Jul 20.
A laboratory-based surveillance study of adult invasive pneumococcal disease was conducted in North-Rhine Westphalia, Germany's most populous federal state, with approximately 18 million inhabitants. Invasive isolates (n = 519) were obtained between 2003 and 2006, before the general recommendation for vaccination of German children <2 years with the pneumococcal conjugate vaccine was issued at the end of July 2006. Penicillin G resistance was observed in 5% of meningitis cases. In the non-meningitis group, only intermediately resistant strains were detected (0.4%). Intermediate resistance to cefotaxime occurred both in meningitis cases (1.7%) and non-meningitis cases (0.4%). Non-susceptibility rates (intermediate resistance and resistance) were 16.2% for macrolides, 10.9% for trimethoprim-sulphamethoxazole, 5.0% for tetracycline, 3.9% for clindamycin, and 0.4% for levofloxacin. All isolates were susceptible to amoxycillin (non-meningitis) and telithromycin. The leading serotypes were serotypes 14 (14.3%), 7F (9.4%), 3 (9.2%), 4 (8.7%) and 1 (8.1%). Serotype coverage for the seven-valent conjugate vaccine was 43.9%. For the ten-valent and 13-valent vaccines (in development), the coverages were 61.8% and 76.7%, respectively. The 23-valent polysaccharide vaccine had a coverage of 91.1%.
一项基于实验室的成人侵袭性肺炎球菌病监测研究在德国人口最多的北莱茵-威斯特法伦州进行，该州约有 1800 万居民。在 2006 年 7 月底德国建议为 2 岁以下儿童常规接种肺炎球菌结合疫苗之前，于 2003 年至 2006 年期间获得了侵袭性分离株（n=519）。在脑膜炎病例中观察到青霉素 G 耐药率为 5%。在非脑膜炎组中，仅检测到中介耐药株（0.4%）。脑膜炎病例（1.7%）和非脑膜炎病例（0.4%）中均存在头孢噻肟中介耐药。大环内酯类的不敏感率（中介耐药和耐药）为 16.2%，复方磺胺甲噁唑为 10.9%，四环素为 5.0%，克林霉素为 3.9%，左氧氟沙星为 0.4%。所有分离株对阿莫西林（非脑膜炎）和替考拉宁均敏感。主要血清型为 14 型（14.3%）、7F 型（9.4%）、3 型（9.2%）、4 型（8.7%）和 1 型（8.1%）。七价结合疫苗的血清型覆盖率为 43.9%。对于十价和十三价疫苗（正在开发中），覆盖率分别为 61.8%和 76.7%。23 价多糖疫苗的覆盖率为 91.1%。
