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Vaccine. 2016 Jan 2;34(1):67-76. doi: 10.1016/j.vaccine.2015.11.015. Epub 2015 Nov 19.

Serotypes, antimicrobial susceptibility, and molecular epidemiology of invasive and non-invasive Streptococcus pneumoniae isolates in paediatric patients after the introduction of 13-valent conjugate vaccine in a nationwide surveillance study conducted in Japan in 2012-2014.

Author information

1
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
2
Department of Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.
3
Department of Respiratory Medicine, Allergy and Rheumatology, Nagoya City University Graduate School of Medical Science, Nagoya, Japan. Electronic address: yutaka@med.nagoya-cu.ac.jp.
4
Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
5
Department of Paediatrics, National Hospital Organization Mie National Hospital, Tsu, Japan.

Abstract

Pneumococcal infection in children is a major public health problem worldwide, including in Japan. The pneumococcal conjugate vaccine 7 (PCV7) was licensed for use in Japan in 2010 followed by PCV13 in 2013. This report includes the results of a nationwide surveillance of invasive pneumococcal disease (IPD) and non-IPD in paediatric patients from January 2012 to December 2014. We collected 343 isolates from 337 IPD patients and 286 isolates from 278 non-IPD patients. Of the IPD isolates, the most identified serotypes included 19A, 24F, and 15A. The prevalence of non-PCV13 serotype isolates increased significantly from 2012 to 2014 (51.6-71.4%, p=0.004). Serotypes 19A, 15A and 35B were highly non-susceptible to penicillin, and the rates of non-susceptible isolates from IPD patients to penicillin and cefotaxime significantly declined during the study period (p=0.029 and p=0.013, respectively). The non-susceptible rate to meropenem increased, particularly for serotype 15A. The IPD isolates comprised clonal complex (CC) 3111 (93.8% was serotype 19A) followed by CC2572 (81.5% was serotype 24F) and CC63 (97.1% was serotype 15A). CC3111, CC63 and CC156 (33.3% was serotype 23A, 28.6% was serotype 6B, and 14.3% was serotype 19A) were highly non-susceptible to penicillin. Of the non-IPD isolates, the most identified serotypes included 19A, 15A, and 3. In conclusion, the introduction of PCV7 and PCV13 resulted in increasing non-PCV13 serotypes and clones, including antimicrobial resistant serotypes 15A and CC63 (Sweden(15A)-25 clone).

KEYWORDS:

Invasive pneumococcal disease; Meropenem resistance; Nation-wide surveillance; PCV13; Paediatric; Streptococcus pneumoniae; Sweden(15A)-25 clone

PMID:
26602268
DOI:
10.1016/j.vaccine.2015.11.015
[Indexed for MEDLINE]
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