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Serotypes of respiratory tract isolates of Streptococcus pneumoniae from Jamaican children

机译:来自牙买加儿童的肺炎链球菌呼吸道分离株的血清型

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Background: Data are lacking on the pneumococcal serotypes present in many developing regions, including the Caribbean. We examined the serotypes of nasopharyngeal (NP) isolates of pneumococci obtained from Jamaican children. Methods: We obtained NP samples from children seen in the Emergency Department at the Bustamante Children's Hospital. The samples were transported to Canada for isolation and serotyping of pneumococci. Results: We obtained 94 isolates from 276 children; median age 3.4 years. The majority (57%) had symptoms of acute respiratory infection at the time of sampling. The main serotypes carried were 6B (20.5%), 19F (14.5%), and 14 (8.4%). Non-typable isolates accounted for 10.8% of the isolates. Fifty-nine per cent of the serotypes were present among the 11 being considered for candidate pneumococcal conjugate vaccines (95% CI 48-70%); the corresponding proportion present in the recently licensed 7-valent vaccine was 57% (95% CI 45-67%). A significant proportion of the serotypes found is absent from those to be included in future conjugate vaccines (P<0.0001; REFERENCE=85% expected serotype representation). Less than 5% of isolates were non-susceptible to penicillin (3.2%), cefotaxime-ceftriaxone (3.2%) and cefuroxime (3.2%), while 8.4% and 1.1% of isolates were resistant to trimethoprim-sulfamethoxazole and erythromycin respectively. There were three isolates with resistance to two or more classes of drug. These isolates were all resistant to penicillin (MIC 2 [mu]g/mL); the serotypes were 14, 23F, and 19F. Conclusion: A significant proportion of the serotypes found is absent from those to be included in future conjugate vaccines.
机译:背景:在包括加勒比海在内的许多发展中地区,缺乏关于肺炎球菌血清型的数据。我们检查了从牙买加儿童获得的肺炎球菌的鼻咽(NP)分离株的血清型。方法:我们从布斯塔曼特儿童医院急诊科的儿童中获得了NP样本。样品被运到加拿大进行肺炎球菌分离和血清分型。结果:我们从276名儿童中获得了94株分离株。中位年龄3.4岁。采样时,大多数(57%)具有急性呼吸道感染症状。携带的主要血清型为6B(20.5%),19F(14.5%)和14(8.4%)。非典型分离株占分离株的10.8%。在考虑用于候选肺炎球菌结合疫苗的11种血清中,有59%的血清型存在(95%CI 48-70%);最近获得许可的7价疫苗中的相应比例为57%(95%CI 45-67%)。发现的血清型中很大一部分与将来的结合疫苗中所含的血清型不一样(P <0.0001;参考值= 85%的预期血清型代表)。不到5%的分离株对青霉素(3.2%),头孢噻肟-头孢曲松(3.2%)和头孢呋辛(3.2%)不敏感,而分离株分别对甲氧苄啶-磺胺甲恶唑和红霉素有抗性。对三种或两种以上药物有抗药性的分离株。这些分离株均对青霉素具有抗性(MIC2μg/ mL);对青霉素具有抗性。血清型分别为14、23F和19F。结论:发现的血清型中很大一部分是未来结合疫苗中所没有的。

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