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Epidemiological survey of invasive pneumococci in Hungary

Abstract number: P1710

Dobay O., Ungvári Á., Szabó J., Hajdú E., Rozgonyi F., Amyes S.G.B., Nagy K.

Objectives:Streptococcus pneumoniae is a major pathogen able to cause severe infections such as pneumonia, sepsis, or meningitis with high mortality rates if not treated correctly. The highest burden of disease is present in young children, and to protect them, the 7-valent conjugate vaccine (PCV7) was developed. As this vaccine was introduced in Hungary at the end of 2005, it was important to get an insight to the situation of pneumococci causing invasive infections in our country.

Methods: One hundred and six non-repeated invasive Streptococcus pneumoniae isolates were collected at seven different diagnostic laboratories throughout Hungary. The species identity of all strains was confirmed by the presence of the lytA gene. Their antibiotic sensitivity to 7 drugs was determined by agar dilution, according to the BSAC guidelines. Serotyping was done both conventionally with antisera and with a PCR-based method. The genetic relatedness of the strains was examined using pulsed-field gel electrophoresis (PFGE).

Results: We had 8 penicillin-resistant (R) strains among the isolates (8.4%, MIC = 2 or 4 mg/L), while there was virtually no resistance to cefotaxim or imipenem. The erythromycin resistance was 41.9%. The resistance to levofloxacin and moxifloxacin were around 3%. The isolates were fully sensitive to telithromycin and vancomycin. The detected serotypes in ranking order were: 6 (mostly 6A, 26.3%), 14 (17.1%), 23 (10.5%), 3 (9.2%), followed by 15, 9, 19, 7, 4, 18, 1, 11 and 8. The penicillin-R strains were of serotypes 14, 23 or 19A. The serotype 23 strains required higher penicillin MICs, but were all sensitive to macrolides. The higher fluoroquinolone MICs were observed mainly for serotypes 3, 4, 18 and 19. Interestingly, serotypes 6, 9 and 23 were mostly isolated from pneumonia. Based on the PFGE results, the strains showed a relatively high genetic diversity.

Conclusions: The antibiotic sensitivity pattern of the strains was similar, but the serotype distribution was different from that previously observed in the general pneumococcal population in Hungary. Based on our data, the theoretical vaccine coverage for the PCV7 (serotypes 4, 6B, 9V, 14, 18C, 19F, 23F) is 51.3%, which is very low. This would increase to 59.2% with the soon coming 10-valent vaccine, and to 89.5% with the future 13-valent vaccine, thus this latter would be very welcomed in Hungary.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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