Serotype distribution of Streptococcus pneumoniae isolated from patients with invasive pneumococcal disease in Brazil before and after ten-pneumococcal conjugate vaccine implementation

Abstract

The ten-pneumococcal conjugate vaccine (PCV10) was introduced into the national immunization program for childhood vaccination schedules by the Brazilian Health Public Service in March 2010. The aim of this study was to compare Streptococcus pneumoniae serotype distribution, antibiotic resistance patterns, and potential coverage before (January 2006-June 2010) and after (July 2010-September 2012) PCV10 introduction. The incidence of invasive pneumococcal disease (IPD), patient demographics, and disease characteristics were recorded. This study was conducted at the University Hospital of Sao Paulo University in Brazil from January 2006 to September 2012. Serotyping was performed using multiplex PCR typing, and antimicrobial sensitivity by Clinical and Laboratory Standards Institute (CLSI). A total of 259 S. pneumoniae strains were isolated from patients with IPD. The ages of the patients ranged from 3 months to 95 years old. The strains were isolated from cerebrospinal fluid, pleural fluid, and blood. The incidence of IPD among patients at HU-USP changed after the introduction of PCV10. The overall incidence of IPD was 3.42 cases per 1000 admissions in the vaccine pre- implementation period and of 2.99 cases per 1000 admissions in the vaccine post-implementation period. The incidence of IPD among children<2 y.o. attended at HU-USP changed significantly after the introduction of PCV10, from 20.30 to 3.97 of incidence. The incidence of PCV10- serotypes decrease from 16.47 to 0.44 in the same age, before and after PC10 implementation, respectively. Moreover, it was possible to realize the sensitivity to penicillin among isolates increased significantly in the post-vaccine period. Data from this study suggest that PCV10 contributed to decrease with PID rate among children less than 2 y.o. The resistance rate among pneumococcal isolates also could be observed since serotypes with greater resistance to beta lactam antibiotics were not easily isolated after vaccination.

Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus pneumoniae in Pre- and Post-Conjugate Vaccine Eras: a United States Perspective

“…In a South African clinical trial for a 9-valent conjugate vaccine, rates of penicillin-resistant IPD and trimethoprim-sulfamethoxazole-resistant IPD decreased by 67% and 56%, respectively (303). dos Santos et al also found that penicillin and ceftriaxone nonsusceptibility decreased after PCV10 introduction in Brazil, although no trend was found for clindamycin, chloramphenicol, erythromycin, rifampin, tetracycline, or levofloxacin (304). In Colombia, penicillin resistance among invasive isolates decreased after PCV7 introduction (41.1% versus 14.2%; P ϭ 0.02) (305).…”

Impact of the pneumococcal 10-valent vaccine on reducing hospitalization for community-acquired pneumonia in children

“…Currently, there are reports of 91 serotypes1 , 2 associated with CAP and other diseases. However, CAP causes greater morbidity and its occurrence is estimated at 13.8 million new cases worldwide each year 3…”

Resistencia antibiótica y distribución de serotipos en cepas neumocócicas invasivas en adultos hospitalizados en Lima, Perú

“…En Latinoamérica, incluyendo este estudio y un estudio colombiano (realizado por grupos etarios) y otro brasileño, el serotipo 14 se encuentra entre los más frecuentes (18,24) . El serotipo 19A es frecuente en otras partes del mundo, como lo reportan estudios de China (135 adultos) y Dinamarca (464 adultos), pero no resultó predominante en nuestro estudio ni en los latinoamericanos en referencia (18,(24)(25)(26) .…”

“…El serotipo 19A es frecuente en otras partes del mundo, como lo reportan estudios de China (135 adultos) y Dinamarca (464 adultos), pero no resultó predominante en nuestro estudio ni en los latinoamericanos en referencia (18,(24)(25)(26) . Las diferencias podrían darse por cambios temporales en la distribución de los serotipos, o por aspectos geográficos.…”