Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru.
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru.
Vaccine. 2023 Jun 23;41(28):4106-4113. doi: 10.1016/j.vaccine.2023.05.042. Epub 2023 Jun 1.
To determinate the frequency of Streptococcus pneumoniae nasopharyngeal carriers, serotypes and antimicrobial resistance in healthy children in Lima, Peru, post-PCV13 introduction and to compare the results with a similar study conducted between 2006 and 2008 before PCV7 introduction (pre-PCV7).
A cross-sectional multicenter study was conducted between January 2018 and August 2019 in 1000 healthy children under two years of age. We use standard microbiological methods to determinate S. pneumoniae from nasopharyngeal swab, Kirby Bauer and minimum inhibitory concentration methods to determinate antimicrobial susceptibility and whole genomic sequencing to determinate pneumococcal serotypes.
The pneumococcal carriage rate was 20.8 % vs. 31.1 % in pre-PCV7 (p < 0.001). The most frequent serotypes were 15C, 19A and 6C (12.4 %, 10.9 % and 10.9 % respectively). The carriage of PCV13 serotypes after PCV13 introduction decreased from 59.1 % (before PCV7 introduction) to 18.7 % (p < 0.001). Penicillin resistance was 75.5 %, TMP/SMX 75.5 % and azithromycin 50.0 %, using disk diffusion. Penicillin resistance rates using MIC breakpoint for meningitis (MIC ≥ 0.12) increased from 60.4 % to 74.5 % (p = 0.001).
The introduction of PCV13 in the immunization program in Peru has decreased the pneumococcal nasopharyngeal carriage and the frequency of PCV13 serotypes; however, there has been an increase in non-PCV13 serotypes and antimicrobial resistance.
在秘鲁利马，确定肺炎球菌鼻咽携带率、血清型和抗生素耐药性在 PCV13 接种后的频率，并与 2006 年至 2008 年 PCV7 接种前（PCV7 前）进行的类似研究进行比较。
2018 年 1 月至 2019 年 8 月，在 1000 名 2 岁以下的健康儿童中进行了一项横断面多中心研究。我们使用标准微生物学方法从鼻咽拭子中确定肺炎链球菌，使用 Kirby Bauer 和最低抑菌浓度方法确定抗生素敏感性，使用全基因组测序确定肺炎球菌血清型。
肺炎球菌携带率在 PCV7 前为 31.1%，PCV13 后为 20.8%（p<0.001）。最常见的血清型为 15C、19A 和 6C（分别为 12.4%、10.9%和 10.9%）。PCV13 血清型在 PCV13 接种后的携带率从 59.1%（PCV7 接种前）下降至 18.7%（p<0.001）。使用纸片扩散法，青霉素耐药率为 75.5%，TMP/SMX 耐药率为 75.5%，阿奇霉素耐药率为 50.0%。使用 MIC 折点（MIC≥0.12）的青霉素耐药率从 60.4%增加到 74.5%（p=0.001）。
秘鲁免疫规划中 PCV13 的引入降低了肺炎球菌鼻咽携带率和 PCV13 血清型的频率；然而，非 PCV13 血清型和抗生素耐药性有所增加。
