黎巴嫩5岁以下儿童的鼻咽部携带情况、抗菌药物耐药性及血清型分布：PCV13引入前的基线数据
Nasopharyngeal Carriage, Antimicrobial Resistance, and Serotype Distribution of in Children Under Five in Lebanon: Baseline Data Prior to PCV13 Introduction.
作者信息
Rafei Rayane, Zaylaa Mazen, Diab Mohamad, Kassem Issmat I, El Omari Khaled, Halimeh Fatima B, El Moujaber Grace, Achour Afaf, Ismail Bassel, Mallat Hassan, Hamze Monzer, Dabboussi Fouad, Osman Marwan
机构信息
Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School for Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
出版信息
Antibiotics (Basel). 2025 Feb 8;14(2):168. doi: 10.3390/antibiotics14020168.
BACKGROUND
The nasopharyngeal carriage of can be the source of transmission between humans and the starting step towards invasive pneumococcal diseases. Data on the carriage of pneumococci in children before and after the pneumococcal conjugate vaccines (PCV) integration in a country are essential for monitoring any change in pneumococcal carriage serotypes and their antimicrobial-resistance profiles.
METHODS
We investigated the epidemiology of carriage among children younger than five years old in Tripoli, Lebanon, in 2016, the same year of integration of PCV13 in the country's Expanded Program on Immunization.
RESULTS
Of 104 participating children, 57 (54.8%) gave a positive culture for . Antimicrobial susceptibility testing revealed that 26.3% of isolates were multidrug-resistant. Resistance was detected mainly against oxacillin (77.2%), tetracycline (29.8%), erythromycin (22.8%), trimethoprim-sulfamethoxazole (22.8%), clindamycin (19.3%), minocycline (19.3%), and teicoplanin (1.8%). Serotyping analysis identified 14 distinct serotypes, with only 31.3% and 50% of isolates corresponding to vaccine serotypes covered by PCV13 and PCV20, respectively. The most common serotypes were 11A, 19F, 23A, and those of serogroup 24 (Sg24) accounted for 37.5% of the serotyped isolates.
CONCLUSIONS
Our findings have revealed the circulation of a pool of pneumococci isolates with high levels of antibiotic resistance and different degrees of likelihood of causing invasive diseases in children under five years old in Tripoli in 2016. The overall limited PCV13 vaccine coverage in this study highlighted the need for vaccines with greater coverage in the immunization programs in Lebanon. Longitudinal national studies investigating the carriage of pneumococci in children are required to further assess the impact of the PCV vaccine on pneumococci carriage in children and steer new vaccine development.
背景
肺炎链球菌的鼻咽部携带可能是人与人之间传播的来源以及侵袭性肺炎球菌疾病的起始步骤。在一个国家引入肺炎球菌结合疫苗（PCV）前后儿童肺炎球菌携带情况的数据对于监测肺炎球菌携带血清型及其抗菌药物耐药谱的任何变化至关重要。
方法
我们于2016年在黎巴嫩的的黎波里调查了5岁以下儿童肺炎链球菌携带的流行病学情况，同年该国的扩大免疫规划引入了PCV13。
结果
在104名参与研究的儿童中，57名（54.8%）肺炎链球菌培养呈阳性。抗菌药物敏感性测试显示，26.3%的分离株对多种药物耐药。主要检测到对苯唑西林（77.2%）、四环素（29.8%）、红霉素（22.8%）、甲氧苄啶-磺胺甲恶唑（22.8%）、克林霉素（19.3%）、米诺环素（19.3%）和替考拉宁（1.8%）的耐药。血清型分析确定了14种不同的血清型，分别只有31.3%和50%的分离株对应于PCV13和PCV20所涵盖的疫苗血清型。最常见的血清型是11A、19F、23A，血清群24（Sg24）的血清型占分型分离株的37.5%。
结论
我们的研究结果揭示了2016年在的黎波里5岁以下儿童中存在一批具有高耐药水平且导致侵袭性疾病可能性不同的肺炎球菌分离株的传播情况。本研究中PCV13疫苗总体覆盖率有限，凸显了黎巴嫩免疫规划中需要覆盖率更高的疫苗。需要开展全国性纵向研究来调查儿童肺炎球菌携带情况，以进一步评估PCV疫苗对儿童肺炎球菌携带的影响并指导新疫苗的研发。
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