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Temporal trends of invasive Streptococcus pneumoniae serotypes and antimicrobial resistance patterns in Spain from

A Fenoll1, J J Granizo, L Aguilar

  • 1National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

Journal of Clinical Microbiology
|February 20, 2009
PubMed

Insights

Pneumococcal conjugate 7-valent vaccine (PCV7) serotypes decreased in Spain after 2000, while non-PCV7 serotypes increased. This shift impacted invasive pneumococcal disease (IPD) trends and antibiotic resistance patterns.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • Invasive pneumococcal disease (IPD) is a significant public health concern.
  • Antibiotic and vaccine pressures have historically influenced the epidemiology of IPD serotypes.
  • Understanding temporal trends is crucial for effective disease control strategies.

Purpose of the Study:

  • To analyze temporal trends of invasive pneumococcal disease (IPD) serotypes in Spain from 1979 to 2007.
  • To assess the impact of antibiotic and vaccine pressures on IPD serotype prevalence and incidence.
  • To investigate the correlation between serotype trends, antibiotic nonsusceptibility, and vaccination programs.

Main Methods:

  • Retrospective analysis of IPD cases in Spain (1979-2007).
  • Serotyping of *Streptococcus pneumoniae* isolates.
  • Statistical analysis of temporal trends in serotype prevalence and IPD incidence.
  • Correlation analysis with antibiotic consumption and vaccination data.

Main Results:

  • Pneumococcal conjugate 7-valent vaccine (PCV7) serotypes generally increased in the 1980s and decreased in the 2000s, with exceptions like serotype 23F.
  • Major non-PCV7 serotypes showed varied trends, with some decreasing in the 1980s and others increasing from the late 1990s.
  • IPD incidence due to PCV7 serotypes decreased, while non-PCV7 serotypes increased, leading to stable overall IPD incidence.
  • Penicillin nonsusceptibility correlated with PCV7 serotypes; erythromycin nonsusceptibility initially rose with macrolide use before declining.

Conclusions:

  • The introduction of PCV7 likely reversed the increasing trends of PCV7 serotypes and associated antibiotic nonsusceptibility observed in the 1980s and 1990s.
  • The decrease in PCV7 serotype IPD was offset by an increase in non-PCV7 serotypes, highlighting serotype replacement.
  • The evolution of pneumococcal serotypes under preventive strategies is serotype-dependent and remains unpredictable.

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