Serotype and antibiotic resistance of isolates from patients with invasive pneumococcal disease in Japan

Abstract

Invasive pneumococcal disease (IPD) is of concern in Japan, where the heptavalent pneumococcal conjugate vaccine (PCV7) is unavailable. We determined serotypes, genotypes indicating beta-lactam resistance, and antibiotic susceptibilities of 496 isolates from normally sterile sites in patients (193 children, 303 adults) from 186 institutions between August 2006 and July 2007. Disease presentations included sepsis (46.2%), pneumonia (31.5%), and meningitis (17.5%). Mortality was 1.4% in children and 22.1% in adults, many of whom had underlying diseases. In children, serotype 6B (22.5%) was followed by 19F (14.1%), and 14 (13.1%); potential coverages of PCV7 and PCV13 were 75.4% and 93.7%, respectively. In adults, serotype 12F (14.3%) was followed by 3 (11.3%), and 6B (10.3%); 23-valent polysaccharide vaccine (PPV23) coverage was 85.4%. Most serotype 12F strains were gPISP, with pbp2b gene alteration; carbapenem had an excellent MIC90. PCV7 is recommended for children and PPV23 for adults to increase prevention against IPD.

Invasive Streptococcus pneumoniae infections in children in Kamikawa and Soya subprefecture, Hokkaido, Japan, 2000–2010, before the introduction of the 7-valent pneumococcal conjugate vaccine

“…They reported that coverages by PCV-7 and PCV-13, respectively, were: Asia 52% and 77%, Europe 72% and 88%, North America 82% and 88%; Central and South America 58% and 82%, Oceania 68% and 79%, and Africa 49% and 77%. When compared with the results of Chiba et al [11] and our results, these results represent higher PCV-7 coverage and similar PCV-13 coverage in Asia. The reason may be that in all of Asia except Japan, there are relatively many strains of serotypes 1 and 5 among the strains of IPD-causing S. pneumoniae.…”

“…Chiba et al [11] examined the serotypes of 191 strains of S. pneumoniae isolated from children with IPD in Japan during 2006 and 2007 and reported that the most frequent was 6B (43 strains), followed by 19F (27 strains), 14 (25 strains), and 23F (23 strains), and that the potential coverages by the PCV-7 and PCV-13 vaccines were 75.4 and 93.7%, respectively. These coverages were slightly higher than those obtained in our study.…”

“…As for resistance status, Chiba et al [11] reported the following: gPRSP, 46.1%; gPISP (pbp2x), 19.9%; gPISP, (pbp1a ? 2x) 12.6%; gPISP (pbp2x ?…”

Molecular epidemiologic characteristics of Streptococcus pneumoniae isolates from children with meningitis in Japan from 2007 through 2009

“…Pneumococcal meningitis among young children and the elderly remains an important cause of morbidity and mortality in Japan [21]. Treatment of bacterial meningitis consists primarily of antimicrobial chemotherapy as recommended in the guidelines edited by the Japanese Society of Neurological Therapeutics, the Japanese Society for Neuroinfectious Diseases, and the Japanese Society of Neurology 2007 [22].…”

Controlled Inflammatory Responses in the Lungs Are Associated with Protection Elicited by a Pneumococcal Surface Protein A-Based Vaccine against a Lethal Respiratory Challenge with Streptococcus pneumoniae in Mice

“…Acquired immunity is achieved through the induction of anti-PS antibodies, protecting vaccinated children against colonization and invasive pneumococcal diseases caused by the serotypes included in the formulations (8,46). The induction of serotype-specific protection is an important issue to be considered, since variation in the prevalent serotypes (from more than 90 serotypes described) among different regions of the world is observed (13,23,49). Several proposals of new vaccines are based on conserved antigens that could confer protection against virtually all pneumococcal serotypes (10,30,32,37,(40)(41)(42).…”