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The changing phenotypes and genotypes of invasive pneumococcal isolates from children in Shenzhen during 2013-2017
Yanmin Bao1, Qing Wang2, Kaihu Yao2
1Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China; Shenzhen Children's Hospital, Shenzhen, China.
Insights
Phenotypes and genotypes of Streptococcus pneumoniae causing invasive pneumococcal diseases (IPDs) in Chinese children are evolving. The 13-valent pneumococcal conjugate vaccine (PCV13) shows high potential coverage, indicating improved protection against IPDs.
Area of Science:
- Microbiology
- Epidemiology
- Vaccinology
Background:
- Phenotypes and genotypes of Streptococcus pneumoniae causing invasive pneumococcal diseases (IPDs) are dynamic.
- Monitoring these changes in pediatric isolates is crucial for public health strategies.
- Understanding pre-vaccine introduction trends informs vaccine efficacy assessments.
Purpose of the Study:
- To analyze antibiotic susceptibility, serotype distribution, and sequence types (STs) of S. pneumoniae isolates from children in China before PCV13 introduction.
- To assess the potential impact of PCV13 on invasive pneumococcal disease prevention in this population.
Main Methods:
- Collected S. pneumoniae strains from children (<14 years) at Shenzhen Children's Hospital (Jan 2013-May 2017).
- Determined serotypes via capsular swelling, antibiotic resistance using E-test, and genotypes via multi-locus sequence typing (MLST).
Main Results:
- Identified 94 S. pneumoniae strains across 15 serotypes; prevalent serotypes included 19F, 19A, 14, 23F, and 6B.
- Characterized 42 STs, with ST271, ST876, and ST320 being most common, associated with serotypes 19F, 14, and 19A respectively.
- PCV13 demonstrated 87.2% potential coverage. Meningitis isolates showed high penicillin (80%) and ceftriaxone (20%) resistance, unlike non-meningitis isolates. High erythromycin resistance (95.7%) was observed, with ermB and mefA/E genes prevalent.
Conclusions:
- Observed shifts in S. pneumoniae phenotypes and genotypes in invasive isolates from Shenzhen Children's Hospital.
- PCV13 offers significant protection against IPDs in Chinese children compared to PCV7.
- Antibiotic usage and vaccination practices likely influence observed epidemiological changes.
Background:
The phenotypes and genotypes of Streptococcus pneumoniae isolated from invasive pneumococcal diseases (IPDs) were changing all the time. To monitor these changes of phenotypes and genotypes of S. pneumoniae isolates from children, we examined antibiotic susceptibility, serotype distribution and sequence types (STs) of S. pneumoniae, which were isolated before the 13-valent pneumococcal conjugate vaccine (PCV13) introduced into China.
Methods:
Strains were isolated from children less than 14 years old between January 2013 and May 2017 from Shenzhen Children's Hospital. Serotypes, antibiotic resistance, and genotypes of these isolates were determined using capsular swelling, E-test, and multi-locus sequence typing, respectively.
Results:
A total of 94 S. pneumoniae strains were isolated, which belonged to 15 serotypes. The five most prevalent serotypes were 19F (25.5%), 19A (19%), 14 (17%), 23F (7.5%), and 6B (9.6%). We found 42 STs for these isolates. The most abundant STs were ST271 (24.4%), ST876 (17%), and ST320 (10.6%), mainly related to 19F, 14, and 19A, respectively. The potential coverage of PCV13 was 87.2%. Among non-meningitis isolates, the resistance rates to penicillin and ceftriaxone were 0% and 2%. However, the meningitis isolates showed high resistance to penicillin (80%) and ceftriaxone (20%). Most of these isolates (95.7%) were resistant to erythromycin, and 66 (70.2%) strains carried the ermB gene and 24 (25.5%) strains carried both the ermB and mefA/E genes. Serotype 19A showed the highest mean minimum inhibitory concentration (MIC) for penicillin (MIC = 1.486) than the other serotypes, but no significant difference in penicillin MIC among the three main STs (ST271, ST320, and ST876).
Conclusions:
The phenotypes and genotypes of invasive pneumococcal isolates from Shenzhen Children's Hospital have changed with the passage of time. Compared with PCV7, PCV13 can more effectively protect Chinese children from IPDs. To some extent, these changes are possibly related to the usage of antibiotics and vaccines.
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