Prevalence of Serotypes and Antimicrobial Resistance ofStreptococcus pneumoniaeStrains Isolated from Brazilian Children with Invasive Infections

Abstract

A laboratory surveillance study was developed in Brazil in 1993 to determine capsular types and antimicrobial susceptibility of Streptococcus pneumoniae strains. By studying 360 strains isolated from children with invasive infections in three different cities, 8 out of 34 types were identified as being the most prevalent and considered as the reference group for further analyses. This group comprised 77.7% of all strains studied, and includes the types 1, 5, 6A/B, 9V, 14, 19F, 19A, and 23F. The prevalence of this reference group was significantly higher among strains isolated from children with pneumonia than meningitis. Similarly, this group was more prevalent among strains isolated from children 3 to 6 years of age than from children under 2 years of age. Most strains (78.6%) were found to be susceptible to penicillin and only 1.4% showed high resistance to this antibiotic. However, intermediate resistance to penicillin was detected in 20% of the strains. This laboratory surveillance will be maintained and extended to other cities of Brazil to better define and monitor the trends of pneumococcal infections for proper control and prevention.

Colonização de orofaringe por Streptococcus pneumoniae em crianças de creches municipais de Taubaté-SP: correlação entre os principais sorotipos e a vacina pneumocócica conjugada heptavalente

“…O sorotipo quatro foi o único sorotipo incluído na vacina que não teve expressão relevante no presente estudo. Dessa forma, considerandose a vacina conjugada heptavalente disponível atualmente, a cobertura vacinal, com relação aos sorotipos mais freqüentemente encontrados, pode ser estimada em 63%, muito próximo aos 59,3% estimados por Brandileone et al 22 , em relação a cepas causadoras de doença invasiva.…”

“…Este sorotipo é mais freqüente-mente encontrado em crianças 22 . Este fenômeno acontece porque a resposta imunológica aos diferentes antígenos polissacarídicos capsulares varia de acordo com a idade 23 .…”

“…Somando-se os dois sorotipos, são responsáveis por 21,5% dos sorotipos colonizadores de orofaringe na população estudada. Esses sorotipos também são freqüentemente encontrados na população pediátrica e resistentes à penicilina, à semelhança do sorotipo 19F 22 .…”

“…Também fazem parte do grupo dos mais freqüentes em crianças e com maior prevalência de resistência à penicilina, e a infecção pneumocócica por esses agentes pode ser prevenida pela vacinação, pelo fato de estes sorotipos fazerem parte da vacina conjugada atualmente disponível 22 .…”

Meeting the challenge: prevention of pneumococcal disease with conjugate vaccines

“…Children of this age group are more likely to be infected by pneumococci and have a decreased susceptibility to penicillin than older children. [12][13][14][15][16][17][18][19] Considering the development of multivalent pneumococcal conjugate vaccines and the results of the first large clinical trial of a pneumococcal 7-valent conjugate vaccine (PNCRM7; Prevenar ® /Prevnar ® ), the objectives of this article are to: a) review the characteristics and methods of transmission/carriage of S. pneumoniae; b) review the clinical epidemiology of pneumococcal diseases (both invasive and noninvasive); c) describe the rationale for vaccination against this pathogenic organism; and d) review the efficacy of the pneumococcal conjugate vaccines currently under investigation or commercially available.…”