Wambugu Peris, Shah Mohammad-Monir, Nguyen Hien-Anh, Le Kim-Anh, Le Huy-Hoang, Vo Hien-Minh, Toizumi Michiko, Bui Minh-Xuan, Dang Duc-Anh, Yoshida Lay-Myint
Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan.
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan.
Pathogens. 2023 Jul 17;12(7):943. doi: 10.3390/pathogens12070943.
is the major bacterial pathogen causing high pneumonia morbidity and mortality in children <5 years of age. This study aimed to determine the molecular epidemiology of detected among hospitalized pediatric ARI cases at Khanh Hoa General Hospital, Nha Trang, Vietnam, from October 2015 to September 2016 (pre-PCV). We performed semi-quantitative culture to isolate . Serotyping, antimicrobial susceptibility testing, resistance gene detection and multi-locus sequence typing were also performed. During the study period, 1300 cases were enrolled and 413 (31.8%) were isolated. School attendance, age <3 years old and prior antibiotic use before admission were positively associated with isolation. Major serotypes were 6A/B (35.9%), 19F (23.7%) and 23F (12.7%), which accounted for 80.3% of vaccine-type pneumococci. High resistance to Clarithromycin, Erythromycin and Clindamycin (86.7%, 85%, 78.2%) and the mutant drug-resistant genes (98.1%), (98.8%), (99.6%) (96.6%) and (30.3%) were detected. MLST data showed high genetic diversity among the isolates with dominant ST 320 (21.2%) and ST 13223 (19.3%), which were mainly found in Vietnam. Non-typeables accounted for most of the new STs found in the study. Vaccine-type pneumococcus and macrolide resistance were commonly detected among hospitalized pediatric ARI cases.
是导致5岁以下儿童肺炎高发病率和高死亡率的主要细菌病原体。本研究旨在确定2015年10月至2016年9月（肺炎球菌结合疫苗接种前）在越南芽庄市庆和综合医院住院的儿科急性呼吸道感染（ARI）病例中检测到的该病原体的分子流行病学情况。我们进行了半定量培养以分离该病原体。还进行了血清分型、抗菌药物敏感性测试、耐药基因检测和多位点序列分型。在研究期间，共纳入1300例病例，分离出413例该病原体（31.8%）。上学、年龄<3岁以及入院前曾使用抗生素与该病原体分离呈正相关。主要血清型为6A/B（35.9%）、19F（23.7%）和23F（12.7%），它们占疫苗型肺炎球菌的80.3%。检测到对克拉霉素、红霉素和克林霉素的高耐药率（分别为86.7%、85%、78.2%）以及突变耐药基因ermB（98.1%）、ermC（98.8%）、mefA（99.6%）、mefE（96.6%）和tetM（30.3%）。多位点序列分型数据显示分离株之间具有高度遗传多样性，优势序列型为ST 320（21.2%）和ST 13223（19.3%），主要在越南发现。非分型菌株占研究中发现的新序列型的大多数。在住院的儿科ARI病例中普遍检测到疫苗型肺炎球菌和大环内酯类耐药情况。
