Grant Lindsay R, Apodaca Kevin, Deshpande Lalitagauri, Kimbrough John H, Hayford Kyla, Yan Qi, Mendes Rodrigo, Cané Alejandro, Gessner Bradford D, Arguedas Adriano
Vaccines and Antivirals, Pfizer Inc., Collegeville, PA, United States.
JMI Laboratories, North Liberty, IA, United States.
Front Pediatr. 2024 Jul 15;12:1383748. doi: 10.3389/fped.2024.1383748. eCollection 2024.
Pneumococcal conjugate vaccines (PCVs), including higher valency vaccines such as PCV20, have the potential to reduce pediatric otitis media. We assessed serotype distribution, potential PCV coverage, and antimicrobial susceptibility of isolates cultured from middle ear fluid (MEF) of US children age ≤5 years.
isolates identified from US hospitals participating in the SENTRY Antimicrobial Surveillance program from 2011 to 2021 were included. Serotypes were determined by in silico analysis based on Pneumococcal Capsular Typing methodology. The percentage of isolates belonging to serotypes included in PCV13 (serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F), PCV15 (PCV13 plus 22F, 33F), and PCV20 (PCV13 plus, 8, 10A, 11A, 12F, 15B, 22F and 33F) was calculated. Antimicrobial susceptibility testing was performed by broth microdilution and interpreted using CLSI criteria. Nonsusceptibility was defined as isolates that were intermediate or resistant to a selected antimicrobial.
Among the 199 isolates that were identified, 56.8% were from children age <2 years. Six serotypes accounted for around 60% of isolates: 35B (16.6%), 15B (14.6%), 15A (7.5%), 19A (7.5%), 19F (7.5%), and 3 (7.0%). Serotypes included in PCV13, PCV15, and PCV20 accounted for 23.1%, 30.2%, and 54.8% of isolates, respectively. Overall, 45.2% of isolates were penicillin non-susceptible, and 13.6% were MDR, of which 48% were serotype 19A. Seven serotypes (19A, 15A, 15B, 15C, 23A, 33F, and 35B) accounted for the majority of non-susceptible isolates.
PCVs, particularly PCV20, may prevent a substantial fraction of otitis media (OM), including OM due to non-susceptible serotypes. The addition of serotypes 15A, 23A, and 35B would improve coverage against susceptible and non-susceptible pneumococcal OM.
肺炎球菌结合疫苗（PCV），包括如PCV20等高价疫苗，有降低儿童中耳炎的潜力。我们评估了从美国5岁及以下儿童中耳积液（MEF）培养的分离株的血清型分布、潜在的PCV覆盖率和抗菌药物敏感性。
纳入2011年至2021年参与哨兵抗菌监测计划的美国医院鉴定的分离株。血清型通过基于肺炎球菌荚膜分型方法的计算机分析确定。计算属于PCV13（血清型1、3、4、5、6A、6B、7F、9V、14、18C、19A、19F、23F）、PCV15（PCV13加22F、33F）和PCV20（PCV13加8、10A、11A、12F、15B、22F和33F）的分离株百分比。抗菌药物敏感性试验通过肉汤微量稀释法进行，并根据CLSI标准进行解释。不敏感性定义为对选定抗菌药物中介或耐药的分离株。
在鉴定的199株分离株中，56.8%来自2岁以下儿童。六种血清型约占分离株的60%：35B（16.6%）、15B（14.6%）、15A（7.5%）、19A（7.5%）、19F（7.5%）和3（7.0%）。PCV13、PCV15和PCV20中包含的血清型分别占分离株的23.1%、30.2%和54.8%。总体而言，45.2%的分离株对青霉素不敏感，13.6%为多重耐药，其中48%为19A血清型。七种血清型（19A、15A、15B、15C、23A、33F和35B）占不敏感分离株的大多数。
PCV，特别是PCV20，可能预防相当一部分中耳炎（OM），包括由不敏感血清型引起的OM。添加15A、23A和35B血清型将提高对易感和不易感肺炎球菌性OM的覆盖率。
