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结合疫苗时代西班牙成人肺炎球菌肺炎的血清型

Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines.

作者信息

Fernández-Delgado Lucía, Càmara Jordi, González-Díaz Aida, Grau Immaculada, Shoji Hisashi, Tubau Fe, Martí Sara, Domínguez Mª Ángeles, Carratalà Jordi, Yuste Jose, Ardanuy Carmen

机构信息

Department of Microbiology, Hospital Universitari de Bellvitge-University of Barcelona-IDIBELL, 08907 Barcelona, Spain.

CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28020 Madrid, Spain.

出版信息

Microorganisms. 2021 Oct 28;9(11):2245. doi: 10.3390/microorganisms9112245.

DOI:10.3390/microorganisms9112245
PMID:34835371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8622595/
Abstract

We studied changes in serotype distribution and antimicrobial susceptibility in adult pneumococcal pneumonia in Spain (2011-2019). Among 895 pneumococci collected (433 bacteremic [BPP] and 462 non-bacteremic [non-BPP]), serotypes 3 (17%), 19A (10%), 8 (6.7%) and 11A (6.7%) were the most frequent. Serotypes 16F, 19A and 24F were associated with old people (≥65) and serotypes 4, 7F, 8, 12F and 19F to young adults. Serotypes 12F, 24F and 1 were significantly more frequent in BPP and serotypes 11A, 23A and 19F in non-BPP. Amoxicillin resistance was higher in non-BPP (17% vs. 11%) while penicillin non-susceptibility (37% vs. 24%) and macrolide resistance (29% vs. 14%) were higher in older adults. In the period 2017-2019, the vaccine coverages were: 32% (PCV13), 39% (PCV15), 65% (PCV20) and 69% (PPV23). Differences were found in serotype composition and antimicrobial resistance by age and type of infection. The maintenance of serotype 3 as a leading cause of adult pneumococcal pneumonia and the increase in highly invasive (serotype 8) or antimicrobial-resistant (serotype 11A) serotypes is worrisome. Further studies will be required to analyse the impact of the upcoming broader conjugate vaccines.

摘要

我们研究了西班牙成人肺炎球菌肺炎（2011 - 2019年）的血清型分布变化及抗菌药物敏感性。在收集的895株肺炎球菌中（433株菌血症性[BPP]和462株非菌血症性[非BPP]），血清型3（17%）、19A（10%）、8（6.7%）和11A（6.7%）最为常见。血清型16F、19A和24F与老年人（≥65岁）相关，血清型4、7F、8、12F和19F与年轻成年人相关。血清型12F、24F和1在菌血症性肺炎中显著更常见，血清型11A、23A和19F在非菌血症性肺炎中更常见。非菌血症性肺炎中阿莫西林耐药性更高（17%对11%），而老年人中青霉素不敏感性（37%对24%）和大环内酯类耐药性（29%对14%）更高。在2017 - 2019年期间，疫苗覆盖率分别为：32%（PCV13）、39%（PCV15）、65%（PCV20）和69%（PPV23）。在血清型组成和抗菌药物耐药性方面发现了年龄和感染类型的差异。血清型3作为成人肺炎球菌肺炎的主要病因持续存在，以及高侵袭性（血清型8）或抗菌药物耐药（血清型11A）血清型的增加令人担忧。需要进一步研究来分析即将推出的更广泛的结合疫苗的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/6f940deaf1de/microorganisms-09-02245-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/6f1abd9538bc/microorganisms-09-02245-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/dcc1e1d46584/microorganisms-09-02245-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/6f940deaf1de/microorganisms-09-02245-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/6f1abd9538bc/microorganisms-09-02245-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/dcc1e1d46584/microorganisms-09-02245-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/8622595/6f940deaf1de/microorganisms-09-02245-g003.jpg

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