Department of Pediatrics, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Clinical Pathology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt.
Eur J Clin Microbiol Infect Dis. 2017 Dec;36(12):2385-2389. doi: 10.1007/s10096-017-3071-z. Epub 2017 Jul 25.
In Egypt, pneumococcal vaccines have not yet been introduced as being compulsory. Identification of the circulating serotypes in Egypt is mandatory to determine whether or not the pneumococcal vaccines will be beneficial. The current study aims to identify the serotypes, vaccine coverage, and antimicrobial resistance of Streptococcus pneumoniae colonizing the nasopharynx of Egyptian children younger than 5 years old. The study was conducted in two successive winter seasons (December 2012-February 2013 and December 2013-February 2014). Two hundred children were enrolled, aged from 6 months to 5 years, excluding those with fever, signs of infection, history of antibiotic intake, and hospitalization in the preceding month. Nasopharyngeal (NP) secretions were collected, subjected to culture, and underwent antibiotic susceptibility testing if positive for pneumococci. Real-time polymerase chain reaction (PCR) and serotyping by sequential multiplex PCR for positive cases were included as well. Streptococcus pneumoniae was isolated from 62 subjects. All isolates were sensitive to vancomycin and levofloxacin, but the majority showed resistance to multiple antibiotics. PCR was positive for pneumococci in 113 subjects (56.5%). The most commonly detected serotypes (st) were 6A6B6C (n = 21, 20.8%), 19F (n = 19, 18.8%), 1 (n = 11, 10.9%), 34 (n = 8, 7.9%), and 19A (n = 6, 5.9%). The theoretical coverage of the PCV13 vaccine for the detected serotypes was 72.4%, while that of PCV10 was 65.5%. Based on these percentages, we recommend including pneumococcal conjugate vaccines in the Egyptian national vaccination program.
在埃及，肺炎球菌疫苗尚未被强制要求接种。为了确定肺炎球菌疫苗是否有益，必须鉴定埃及流行的血清型。本研究旨在鉴定 5 岁以下埃及儿童鼻咽部定植的肺炎链球菌的血清型、疫苗覆盖率和抗菌药物耐药性。该研究分两个连续的冬季（2012 年 12 月至 2013 年 2 月和 2013 年 12 月至 2014 年 2 月）进行。共纳入 200 名年龄在 6 个月至 5 岁之间的儿童，排除发热、感染迹象、抗生素使用史和前一个月住院的儿童。采集鼻咽（NP）分泌物，培养后对阳性的肺炎球菌进行药敏试验。还包括实时聚合酶链反应（PCR）和阳性病例的连续多重 PCR 血清分型。从 62 名受试者中分离出肺炎链球菌。所有分离株均对万古霉素和左氧氟沙星敏感，但大多数对多种抗生素耐药。PCR 对 113 名受试者（56.5%）的肺炎球菌呈阳性。最常见的检测到的血清型（st）是 6A6B6C（n=21，20.8%）、19F（n=19，18.8%）、1（n=11，10.9%）、34（n=8，7.9%）和 19A（n=6，5.9%）。检测到的血清型的 PCV13 疫苗理论覆盖率为 72.4%，而 PCV10 的覆盖率为 65.5%。根据这些百分比，我们建议在埃及国家免疫规划中纳入肺炎球菌结合疫苗。
