日本成年肺炎患者中非疫苗血清型肺炎链球菌的临床特征及抗菌药敏性
Clinical characteristics and antimicrobial susceptibility of non-vaccine serotype Streptococcus pneumoniae in adult Japanese patients with pneumonia.
作者信息
Akata Kentaro, Yamasaki Kei, Noguchi Shingo, Chang Bin, Nemoto Kazuki, Ikegami Hiroaki, Kawanami Toshinori, Mukae Hiroshi, Yatera Kazuhiro
机构信息
Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
出版信息
J Infect Chemother. 2023 Oct 28. doi: 10.1016/j.jiac.2023.10.018.
BACKGROUND
Non-vaccine serotype (NVT) pneumococcal pneumonia in Japan has increased with the spread of pneumococcal vaccinations. However, there is no data regarding the clinical background and antimicrobial susceptibility of NVT isolates compared with those of vaccine serotype (VT) isolates in adult pneumococcal pneumonia.
METHODS
The serotypes and antimicrobial susceptibilities of pneumococcal isolates obtained from patients with pneumonia at the University of Occupational and Environmental Health, Japan, from January 2011 to December 2020 were retrospectively evaluated along with the patients' clinical information.
RESULTS
In total, 252 patients with pneumococcal pneumonia (98 NVT and 154 VT isolates) were included. Among NVTs, the most common serotype was 35B, followed by 15A, 34, 6C, 23A, and 15C. The MIC and MIC of each antibiotic in 35B and 15A tend to be higher than those in 34, 6C, and 23A. Regarding background characteristics, the percentages of patients with dementia and liver disease were significantly higher in patients in the VT group than in those in the NVT group (p = 0.048 and p = 0.012, respectively). There were no significant differences in the severity of pneumonia and mortality rate between patients with the VT and NVT isolates. This study first demonstrated that NVT isolates included those with reduced susceptibility to antibiotics in adult pneumonia in Japan. The data of the present study can be useful in optimizing treatment strategies for pneumococcal pneumonia because of the increasing number of NVT cases in Japan.
背景
随着肺炎球菌疫苗接种的普及，日本非疫苗血清型（NVT）肺炎球菌肺炎有所增加。然而，在成人肺炎球菌肺炎中，与疫苗血清型（VT）分离株相比，关于NVT分离株的临床背景和抗菌药敏性尚无数据。
方法
回顾性评估了2011年1月至2020年12月在日本职业与环境卫生大学从肺炎患者中分离出的肺炎球菌分离株的血清型和抗菌药敏性，并结合患者的临床信息。
结果
总共纳入了252例肺炎球菌肺炎患者（98株NVT和154株VT分离株）。在NVT中，最常见的血清型是35B，其次是15A、34、6C、23A和15C。35B和15A中每种抗生素的最低抑菌浓度（MIC）往往高于34、6C和23A中的MIC。关于背景特征，VT组患者中痴呆和肝病患者的百分比显著高于NVT组患者（分别为p = 0.048和p = 0.012）。VT和NVT分离株患者之间的肺炎严重程度和死亡率没有显著差异。本研究首次表明，在日本成人肺炎中，NVT分离株包括对抗生素敏感性降低的菌株。由于日本NVT病例数量不断增加，本研究的数据可能有助于优化肺炎球菌肺炎的治疗策略。
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