Miyazaki Taiga, van der Linden Mark, Hirano Katsuji, Maeda Takahiro, Kohno Shigeru, Gonzalez Elisa N, Zhang Pingping, Isturiz Raul E, Gray Sharon L, Grant Lindsay R, Pride Michael W, Gessner Bradford D, Jodar Luis, Arguedas Adriano G
Nagasaki University, Nagasaki, Japan.
Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Front Microbiol. 2024 Sep 24;15:1458307. doi: 10.3389/fmicb.2024.1458307. eCollection 2024.
is an important cause of community-acquired pneumonia (CAP) in Japan. Here, we report the serotype distribution and antimicrobial susceptibility of cultured pneumococcal isolates from Japanese adults aged ≥18 years with CAP. This was a prospective, population-based, active surveillance study conducted in Goto City, Japan from December 2015 to November 2020. Pneumococcal isolates from sterile sites (blood and pleural fluid) and non-sterile sites (sputum and bronchoalveolar lavage) were cultured as part of the standard of care. were serotyped using the Quellung reaction. Antimicrobial susceptibility was tested using microdilution and interpreted according to the Clinical and Laboratory Standards Institute criteria. Isolates resistant to erythromycin were phenotyped using the triple-risk test and genotyped by polymerase chain reaction. A total of 156 pneumococcal isolates were collected (138 from sputum, 15 from blood, and 3 from bronchoalveolar lavage) from 1992 patients. Of these, 142 were non-duplicate isolates from unique patients and were included in the analyses. Serotypes contained within the 13-valent pneumococcal conjugate vaccine (PCV13) (including 6C), PCV15 (including 6C), and PCV20 (including 6C and 15C) were detected in 39 (27%), 45 (32%), and 80 (56%) of 142 isolates, respectively. The most common serotypes were 35B (12%), 11A (11%), and 3 (11%). Multidrug resistance (MDR) was detected in 96/142 (68%) isolates. Of the 96 MDR isolates, 31, 32, and 59% were PCV13, PCV15, and PCV20 serotypes, respectively; the most common MDR serotypes were 35B (16%), 6C, 10A, and 15A (9% each), and 3 and 11A (8% each). A total of 119 isolates were resistant to macrolides; 41 (35%) had an M phenotype, 53 (45%) had an iMcLS phenotype, and 25 (21%) had a cMLS phenotype. In conclusion, pneumococcal serotypes 35B, 11A and 3 were most frequently associated with pneumonia and antimicrobial resistance was common among pneumococcal isolates from adults with CAP in Goto City, Japan. Implementing higher-valency PCVs May help reduce vaccine-type CAP among Japanese adults.
在日本，它是社区获得性肺炎（CAP）的一个重要病因。在此，我们报告了来自日本≥18岁CAP成年患者的培养肺炎球菌分离株的血清型分布及抗菌药物敏感性。这是一项于2015年12月至2020年11月在日本五岛市开展的前瞻性、基于人群的主动监测研究。作为标准治疗的一部分，对来自无菌部位（血液和胸腔积液）和非无菌部位（痰液和支气管肺泡灌洗）的肺炎球菌分离株进行培养。使用荚膜肿胀反应对其进行血清分型。使用微量稀释法检测抗菌药物敏感性，并根据临床和实验室标准协会的标准进行解读。对红霉素耐药的分离株使用三重风险试验进行表型分析，并通过聚合酶链反应进行基因分型。从1992例患者中总共收集了156株肺炎球菌分离株（138株来自痰液，15株来自血液，3株来自支气管肺泡灌洗）。其中，142株为来自不同患者的非重复分离株，并纳入分析。在142株分离株中，分别在39株（27%）、45株（32%）和80株（56%）中检测到13价肺炎球菌结合疫苗（PCV13）（包括6C）、PCV15（包括6C）和PCV20（包括6C和15C）所含的血清型。最常见的血清型为35B（12%）、11A（11%）和3（11%）。在96/142（68%）株分离株中检测到多重耐药（MDR）。在96株MDR分离株中，分别有31%、32%和59%为PCV13、PCV15和PCV20血清型；最常见的MDR血清型为35B（16%）、6C、10A和15A（各9%），以及3和11A（各8%）。总共119株分离株对大环内酯类耐药；41株（35%）具有M表型，53株（45%）具有iMcLS表型，25株（21%）具有cMLS表型。总之，肺炎球菌血清型35B、11A和3与肺炎最常相关，在日本五岛市成年CAP患者的肺炎球菌分离株中抗菌药物耐药很常见。实施更高价的PCV可能有助于减少日本成年人中疫苗型CAP的发生。
