Pneumococcal serotypes in children, clinical presentation and antimicrobial susceptibility in the PCV13 era. (5th November 2020)

• Record Type: Journal Article
• Authors: Izquierdo, C.; Ciruela, P.; Hernández, S.; García-García, J. J.; Esteva, C.; Moraga-Llop, F.; Díaz-Conradi, A.; Martínez-Osorio, J.; Solé-Ribalta, A.; de Sevilla, M. F.; González-Peris, S.; Codina, G.; Planes, A. M.; Uriona, S.; Campins, M.; Muñoz-Almagro, C.; Salleras, L.; Domínguez, A.
• Is Part Of: Epidemiology and infection. Volume 148(2020)
• Publication Date: 2020-11-05
• Subjects: Antimicrobial susceptibility, -- invasive pneumococcal disease, -- PCV13 vaccine, -- penicillin resistance, -- serotype distribution, -- Streptococcus pneumoniae; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268820002708
• Languages: English
• ISSNs: 0950-2688

Abstract

Abstract: 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.