法国侵袭性肺炎球菌感染：基于法国区域肺炎球菌观察网络的数据，2009 年至 2021 年肺炎链球菌对抗生素耐药性和血清型分布的变化。

Invasive pneumococcal infections in France: Changes from 2009 to 2021 in antibiotic resistance and serotype distribution of Streptococcus pneumoniae based on data from the French Regional Pneumococcal Observatories network.

机构信息

Observatoire Régional du Pneumocoque Île-de-France Ouest, Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Service de Bactériologie, Paris, France.

Centre National de Référence des Pneumocoques (CNRP), Centre de Recherche Clinique et Biologique, Centre Hospitalier Intercommunal de Créteil, Créteil, France.

出版信息

Infect Dis Now. 2023 Feb;53(1):104632. doi: 10.1016/j.idnow.2022.11.001. Epub 2022 Nov 12.

DOI:10.1016/j.idnow.2022.11.001

PMID:36375765

Abstract

OBJECTIVE

The 23 French Regional Pneumococcal Observatories (ORPs) analyzed antibiotic resistance and serotypes of Streptococcus pneumoniae strains isolated from invasive infections in France over a 12-year period.

METHODS

Between 2009 and 2021, the ORPs analyzed 19,319 strains, including 1,965 in children and 17,354 in adults. Strains were assessed for their resistance to penicillin G, amoxicillin and cefotaxime. Serotypes were identified in collaboration with the National Reference Centre.

RESULTS

During this period, the number of strains collected yearly decreased significantly. The decrease was particularly pronounced up until 2013, especially in children (-61.0%). However, penicillin non-susceptible strains (PNSPs) increased in children (24.7% in 2009 vs 45.0% in 2021, p < 0.0001) and in adults (27.1% in 2009 vs 31.3% in 2021, p < 0.05), as well as resistance (I + R) to amoxicillin (children: 12.5% in 2009 vs 19.4% in 2021, p < 0.05; adults: 13.4% in 2009 vs 14.5% in 2021, NS) and resistance (I + R) to cefotaxime (children: 8.0% in 2009 vs 13.1% in 2021, p < 0.05; adults: 7.1% in 2009 vs 11.9% in 2021, p < 0.0001). All in all, the proportion of strains belonging to serotypes present in the PCV13 vaccine has fallen sharply, from 64.8% in 2009 to 23.6 % in 2021. At the same time, serotypes such as 8, 10A, 11A, 15B/C and 9N, not included in PCV13, were increasing.

CONCLUSION

During the study period, data collected by the network highlighted an increase of invasive PNSPs in children and non-vaccine serotypes. Surveillance of resistance and serotypes remains instrumental, particularly to monitor the evolution of vaccine efficacy.

摘要

目的

23 个法国区域肺炎球菌观察站（ORP）分析了法国在 12 年间侵袭性感染分离出的肺炎链球菌株的抗生素耐药性和血清型。

方法

2009 年至 2021 年间，ORP 分析了 19319 株菌株，包括儿童 1965 株和成人 17354 株。评估了菌株对青霉素 G、阿莫西林和头孢噻肟的耐药性。血清型与国家参考中心合作确定。

结果

在此期间，每年收集的菌株数量显著减少。这种减少在 2013 年前尤为明显，尤其是儿童（-61.0%）。然而，儿童中青霉素不敏感菌株（PNSP）增加（2009 年 24.7%比 2021 年 45.0%，p<0.0001），成人中青霉素不敏感菌株增加（2009 年 27.1%比 2021 年 31.3%，p<0.05），儿童中阿莫西林（I+R）耐药性（2009 年 12.5%比 2021 年 19.4%，p<0.05）和头孢噻肟（I+R）耐药性（2009 年 8.0%比 2021 年 13.1%，p<0.05）也有所增加。儿童（2009 年 13.4%比 2021 年 14.5%，NS）和头孢噻肟（I+R）耐药性（2009 年 7.1%比 2021 年 11.9%，p<0.0001）均有所增加。总的来说，属于 PCV13 疫苗中存在血清型的菌株比例急剧下降，从 2009 年的 64.8%降至 2021 年的 23.6%。与此同时，8、10A、11A、15B/C 和 9N 等未包含在 PCV13 中的血清型正在增加。