Pneumococcal serotypes in children, clinical presentation and antimicrobial susceptibility in the PCV13 era


Por: Izquierdo C, Ciruela P, Hernández S, García-García JJ, Esteva-Afonso C, Moraga-Llop F, Álvaro Díaz Conradi, Johanna Martínez Osorio, Solé-Ribalta A, MARIA FERNANDEZ DE SEVILLA ESTRACH, González-Peris S, Codina G, Planes AM, Uriona S, Campins M, Munoz-Almagro C, Salleras L and Domínguez A

Publicada: 5 nov 2020 Ahead of Print: 5 nov 2020
Resumen:
The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged <= 17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012-June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2-4 years and 26.9% 5-17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33-22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56-8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2-4 years and 5-17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged <= 17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.

Filiaciones:
Izquierdo C:
 Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain

Ciruela P:
 Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain

 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

Hernández S:
 Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain

García-García JJ:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

 Malalties prevenibles amb vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain

Esteva-Afonso C:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

 Malalties prevenibles amb vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain

Moraga-Llop F:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Álvaro Díaz Conradi:
 Hospital de Nens, Barcelona, Spain

Johanna Martínez Osorio:
 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

Solé-Ribalta A:
 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

MARIA FERNANDEZ DE SEVILLA ESTRACH:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

 Malalties prevenibles amb vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain

González-Peris S:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Codina G:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Planes AM:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Uriona S:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Campins M:
 Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Munoz-Almagro C:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Hospital Sant Joan de Deu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain

 Malalties prevenibles amb vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain

 Departament de Medicina. Universitat Internacional de Catalunya, Barcelona, Spain

Salleras L:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Departament de Medicina, Universitat de Barcelona, Barcelona, Spain

Domínguez A:
 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

 Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
ISSN: 09502688





Epidemiology & Infection
Editorial
CAMBRIDGE UNIV PRESS, EDINBURGH BLDG, SHAFTESBURY RD, CB2 8RU CAMBRIDGE, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 148 Número:
Páginas: 1-37
WOS Id: 000594683100001
ID de PubMed: 33148361
imagen Green Submitted, gold

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