Tóthpál Adrienn, Kardos Szilvia, Laub Krisztina, Nagy Károly, Tirczka Tamás, van der Linden Mark, Dobay Orsolya
Institute of Medical Microbiology, Semmelweis University, Budapest, Nagyvárad tér 4, 1089, Hungary,
Eur J Pediatr. 2015 Mar;174(3):373-81. doi: 10.1007/s00431-014-2408-1. Epub 2014 Sep 2.
Streptococcus pneumoniae is responsible for a significant amount of morbidity and mortality worldwide. Healthy carriers, mainly young children, are the most important sources of infections. In the current study, we aimed to determine the changes that have occurred since the introduction of PCV-7 in Hungary. Nasal specimens were collected from 1,022 healthy children aged 3-6 years attending day-care centres. After thorough identification, pneumococcal isolates were serotyped, and their antibiotic sensitivity was determined. The carriage rate was found to be 34.9%. A huge serotype rearrangement was detected compared to earlier results, with the previously leading serotype 14 having completely disappeared. Serotypes 11A, 35F, 19A, 6B, 15B, 3 and 38 were most prevalent, and 29 different types were identified in total. The PCV-7 types were responsible for 16.5% of all serotypes, and 36.0% are not covered by any pneumococcal vaccines. The isolates were sensitive to most tested antibiotics, except erythromycin (resistance was 21.6%). Only one penicillin-resistant strain was found. The newly and rapidly emerging non-vaccine serotypes are much more sensitive, except serotype 19A.
Due to PCV vaccination, a complete serotype arrangement occurred also in Hungary. The old "paediatric" serotypes were replaced by serotypes 11A, 35F, 19A, 6B, 15B, 3 and 38.
肺炎链球菌在全球范围内导致了大量的发病和死亡。健康携带者,主要是幼儿,是最重要的感染源。在本研究中,我们旨在确定自匈牙利引入PCV-7以来所发生的变化。从1022名3至6岁在日托中心就读的健康儿童中采集鼻拭子样本。经过全面鉴定后,对肺炎球菌分离株进行血清分型,并测定其抗生素敏感性。发现携带率为34.9%。与早期结果相比,检测到巨大的血清型重排,先前占主导地位的血清型14已完全消失。血清型11A、35F、19A、6B、15B、3和38最为常见,总共鉴定出29种不同类型。PCV-7型血清型占所有血清型的16.5%,36.0%的血清型未被任何肺炎球菌疫苗覆盖。除红霉素外(耐药率为21.6%),分离株对大多数测试抗生素敏感。仅发现一株耐青霉素菌株。新出现且迅速增多的非疫苗血清型除19A血清型外更为敏感。
由于PCV疫苗接种,匈牙利也发生了完全的血清型排列变化。旧的“儿科”血清型被血清型11A、35F、19A、6B、15B、3和38所取代。