Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, Republic of Korea.
Vaccine. 2012 Apr 5;30(17):2728-37. doi: 10.1016/j.vaccine.2012.01.091. Epub 2012 Feb 11.
Streptococcus pneumoniae (SP) causes significant burden of disease, including invasive pneumococcal disease and noninvasive diseases such as pneumonia and acute otitis media. SP has at least 93 different capsular serotypes, with the various serotypes having different propensities for producing disease or developing antibiotic resistance. An increase in the prevalence of antibiotic-resistant SP serotypes has been observed globally. The objective of this paper was to examine the relationship between antibiotic resistance and SP serotypes, with a primary focus on studies published in the past 10 years. Changing trends in antibiotic resistance and serotype distribution during this time, including those before and after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7), were analyzed. Factors that influence the prevalence of antibiotic-resistant serotypes include antibiotic selection pressure, the use of PCV7, and the emergence and spread of antibiotic-resistant clones. The emergence of multidrug resistant serotype 19A is of particular concern. Antibiotic-resistant SP is a global problem that must be addressed through multiple strategies, including national vaccination programs, antibiotic control programs, and ongoing surveillance.
肺炎链球菌（SP）可引起严重疾病负担，包括侵袭性肺炎球菌病和非侵袭性疾病，如肺炎和急性中耳炎。SP 至少有 93 种不同的荚膜血清型，不同血清型引起疾病或产生抗生素耐药性的倾向不同。全球范围内观察到抗生素耐药性 SP 血清型的流行率增加。本文的目的是研究抗生素耐药性与 SP 血清型之间的关系，主要关注过去 10 年发表的研究。分析了在此期间抗生素耐药性和血清型分布的变化趋势，包括 PCV7 引入前后的变化趋势。影响抗生素耐药血清型流行率的因素包括抗生素选择压力、PCV7 的使用以及抗生素耐药克隆的出现和传播。多药耐药血清型 19A 的出现尤其令人关注。抗生素耐药性 SP 是一个全球性问题，必须通过多种策略来解决，包括国家疫苗接种计划、抗生素控制计划和持续监测。
