Serotype distribution of pneumococci isolated from pediatric patients with acute otitis media and invasive infection, and potential coverage of pneumococcal conjugated vaccines

Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Combate de los Pozos 1881 (1245) Ciudad Autónoma de Buenos Aires, Argentina.
Revista Argentina de microbiología (Impact Factor: 0.8). 04/2013; 45(1):27-33.
Source: PubMed


A 16-month prospective, descriptive study was conducted on pneumococcal serotype distribution isolated from children with acute otitis media (AOM) and invasive infections (INV). Eighty-nine children with pneumococcal INV and 324 with a first episode of AOM were included. Bacterial pathogens (N = 326) were isolated from the middle-ear fluid of 250 patients. A total of 30 pneumococcal serotypes were identified. Prevalent serotypes were 14, 19A, 9V, 3, 19F, 6A, 23F, and 18C in AOM and 14, 1, 19A, 5, 12F, 6B, and 18C in INV. Potential coverage with PCV10 vaccine would be 46.5 % and 60.7 % for pneumococci involved in AOM and INV, respectively; it would be 71.7 % and 73 % with PCV13. PCV10, conjugated with a Haemophilus protein, would have an immunologic coverage of 39.9 % for AOM vs. 18.5 % with PCV13. However, differences in the prevention of INV were crucial for the decision to include the 13-valent vaccine in the national calendar for children less than two years old in Argentina.

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Available from: Horacio A Lopardo, Apr 20, 2015
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    • "This finding is similar to that recently reported in a study from China, which demonstrated that serotype 19A strains were more frequently isolated from children with IPD [22]. However, our findings differed from those recently reported in a study from Argentina, which showed that serotypes 14, 1, 19A, 5, 12F, 6B, and 18C were the most prevalent serotypes in patients with IPD [23]. In our study, serotype 23A was the second most common serotype in adult patients (15.9%), but only accounted for 9.7% of cases of IPD in children. "
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    ABSTRACT: It is essential to investigate the serotype distribution of pneumococcal diseases in each region and its associated clinical features. This study investigated the annual incidence of invasive pneumococcal disease (IPD) and the distribution of serotypes of isolates causing IPD at a medical center in northern Taiwan during the period 2000 to 2012. Serotypes of all available Streptococcus pneumoniae isolates causing IPD were determined using the latex agglutination test. During the study period, the annual incidence (per 10,000 admissions) of IPD decreased significantly from 9.8 in 2000 to 2.1 in 2012 (P < 0.001). The annual incidence of all-cause bacteremia, primary pneumococcal bacteremia, bacteremic pneumonia, peritonitis, and meningitis also decreased significantly during the study period (P < 0.05). In contrast to the decrease in annual incidence of pneumococcal serotypes 14, 23F and 6B, the incidence and the proportion of serotype 19A significantly increased with time (P < 0.001). The coverage rate of 7-valent protein conjugated vaccine (PCV-7) and PCV-10 decreased significantly; however, the coverage rate of PCV-13 and pneumococcal polysaccharide vaccine (PPV-23) remained stable over time. Serotype 14 and 19A isolates were commonly isolated from blood and pleural effusion, respectively. Serotypes 14 and 23F were the two most common serotypes found in adult patients, and serotypes 14 and 19A were the two most common serotypes isolated from children. Although the incidence of IPD has decreased, serotype 19A is an emerging problem in Taiwan. The distribution of serotypes of pneumococci varied with clinical symptoms and age. As the changing distribution of pneumococcal serotype with time, the coverage rate of pneumococcal vaccines would be different.
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