Epidemiology of invasive Streptococcus pneumoniae in Taiwan, 20012003
Abstract number: 1733_249
Chen C-J., Huang Y-C., Su L-H., Lin T-Y.
Objectives: To characterise the microbiological features of Streptococcus pneumoniae invasive isolates from a tertiary care hospital in Taiwan before the introduction of 7-valent pneumococcal conjugate vaccine (PCV).
Methods: Between January 2001 and December 2003, a total of 272 invasive isolates (115 from children and 157 from adults) were collected from the clinical microbiologic laboratory of Chang Gung Memorial Hospital. The susceptibilities to various antibiotics, the serotypes and pulsed field gel electrophoresis (PFGE) typing were determined in all isolates.
Results: Of 272 isolates, 12 serogroups (18 serotypes) and 78 PFGE types were identified. The most frequent serotypes were types 14 (30.1%), followed by 23F (20.6%), 6B (16.2), 19F (7.4%), 3 (5.9%) and 9V (4.0%). The serotype distributions were similar in children and adults, except for serotype 9V, which was identified exclusively in adult isolates. The genotypes of isolates were diverse and a variety of PFGE types were identified in isolates with same serotype. However, it was not uncommon to identify predominant clones of isolates in each of the six most common serotypes. The non-susceptible rate to penicillin was 73.9% and the incidence of high-level resistance (MIC ≥ 2 ug/mL) was 43.4%. The isolates also demonstrated high rate of resistance to erythromycin (91.2%), cefuroxime (55.5%) and ceftriaxone (29.0%). The isolates expressing PCV-serotypes comprised 95.0% of the penicillin-non-susceptible strains. When compared to the isolates from adults, the isolates from children had a significant higher rate of resistance to penicillin (80.9% vs. 68.8%, p = 0.025) and erythromycin (95.7% vs. 87.9%, p = 0.0259) but a lower resistant rate to ceftriaxone (21.7% vs. 37.4%, p = 0.0231). The coverage of 23-valent polysaccharide vaccine and 7-valent PCV of the serotypes was 91.5% and 83.0%, respectively, in children; and 85.7% and 78.6%, respectively, in adults.
Conclusion: In Taiwan, the invasive isolates of S. pneumoniae harboured high-level resistances to macrolide and b-lactams and exhibited distinct resistant profile between strains from children and adults. The current commercial pneumococcal vaccines had adequate coverage of the serotypes among the pneumococcal invasive diseases.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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