International Health Management Associates, 2122 Palmer Drive, Schaumburg, IL 60173, USA.
Vaccine. 2013 Oct 1;31(42):4881-7. doi: 10.1016/j.vaccine.2013.07.054. Epub 2013 Aug 6.
Streptococcus pneumoniae remains a leading cause of disease in children and adults. Serotypes differ in invasiveness, virulence, and antibiotic resistance; therefore, serotype surveillance is necessary to monitor the burden of pneumococcal disease, especially in the setting of pneumococcal vaccination programs. The Tigecycline Evaluation Surveillance Trial, (TEST), is an on-going global antibiotic susceptibility surveillance program. Serotypes and antibiotic susceptibilities of 2173 invasive S. pneumoniae in this existing database during 2004-2008 were evaluated. Worldwide, serotypes 19A (28%), 19F (10%) and 14 (9%) were the most common in children under 5 years. In adults over 16 years, 19A (13%), 3, 6A and 7F (all 7%) were most common. Serotypes 19A, 6A, 19F, 6B, 15A, 9V, and 14 exhibited significantly higher levels of erythromycin resistance (P<0.05), while 19A, 19F, 35B, 6A, 6B, 23A, 9V, 15A, and 14 demonstrated higher rates of penicillin resistance (P<0.05). This analysis of an existing pathogen database provides a snapshot of global serotype data and describes the consequential issue of antibiotic resistance in specific serotypes, many of which are increasingly common causes of invasive pneumococcal disease.
肺炎链球菌仍然是导致儿童和成人患病的主要原因。血清型在侵袭性、毒力和抗生素耐药性方面存在差异；因此，需要进行血清型监测，以监测肺炎球菌疾病的负担，特别是在肺炎球菌疫苗接种计划的背景下。替加环素评估监测试验（TEST）是一个正在进行的全球抗生素敏感性监测计划。对 2004 年至 2008 年期间该现有数据库中 2173 例侵袭性肺炎链球菌的血清型和抗生素敏感性进行了评估。在全球范围内，血清型 19A（28%）、19F（10%）和 14（9%）是 5 岁以下儿童中最常见的血清型。在 16 岁以上的成年人中，19A（13%）、3、6A 和 7F（均为 7%）最为常见。血清型 19A、6A、19F、6B、15A、9V 和 14 对红霉素的耐药性显著升高（P<0.05），而 19A、19F、35B、6A、6B、23A、9V、15A 和 14 对青霉素的耐药率更高（P<0.05）。对现有病原体数据库的分析提供了全球血清型数据的快照，并描述了特定血清型抗生素耐药性的相关问题，其中许多血清型越来越成为侵袭性肺炎球菌病的常见病因。
