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Published on: September 11, 2020
Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae causing invasive diseases in China: a
Jinjian Fu1,2, Rongsong Yi3, Yongjiang Jiang4
1Department of Laboratory Medicine, Liuzhou Maternity and Child Health Care Hospital, Liuzhou, 545001, Guangxi, China.
Insights
Invasive pneumococcal disease (IPD) in China is primarily caused by serotypes 19F, 19A, and 14. The pneumococcal conjugate vaccine PCV13 covers 90% of these serotypes, offering significant health benefits for children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Invasive pneumococcal disease (IPD) poses a significant threat to children's health globally.
- Understanding the epidemiology of IPD, including prevalent serotypes and antibiotic resistance patterns, is crucial for effective prevention and control strategies.
Purpose of the Study:
- To systematically review and summarize the available data on IPD in children in mainland China.
- To identify the predominant Streptococcus pneumoniae serotypes and assess their antibiotic resistance profiles.
- To evaluate the potential impact of pneumococcal conjugate vaccines (PCVs) in the Chinese context.
Main Methods:
- A systematic review of 16 eligible studies was conducted.
- A random-effects model was employed to estimate the pooled prevalence of IPD.
- Serotype distribution, vaccine coverage, and antibiotic resistance rates were analyzed.
Main Results:
- The most prevalent serotypes were 19F (27.7%), 19A (21.2%), and 14 (16.5%).
- Pneumococcal conjugate vaccine PCV13 demonstrated 90% serotype coverage.
- High rates of antibiotic resistance were observed, with 32.0% resistance to penicillin and over 90% resistance to erythromycin and clindamycin.
Conclusions:
- PCV13 exhibits high coverage for the predominant serotypes causing IPD in Chinese children.
- The high prevalence of antibiotic-resistant strains underscores the importance of vaccination.
- Implementing PCV13 into China's Expanded Program on Immunizations (EPI) is recommended to improve public health outcomes.
Background:
To summarize information about invasive pneumococcal disease (IPD) among children in mainland China.
Methods:
Sixteen eligible studies were included in this systematic review and the random effect model was used to estimate the pool prevalence of IPD.
Results:
The most predominant serotypes circulating in children were 19F (27.7, 95% confidence interval (95% CI): 17.7-37.6%), 19A (21.2%, 16.4-26.1%), 14 (16.5%, 12.8-20.1%), 6B (8.6%, 5.2-10.8%) and 23F (7.3%, 5.2-9.5%). The serotype coverage of the available pneumococcal conjugate vaccines PCV7, PCV10, and PCV13 was 60.8% (52.5-69.4%), 65.1% (57.7-72.4%), and 90.0% (87.1-92.8%), respectively. The pooled antibiotic resistance rates of Streptococcus pneumoniae revealed a resistance to penicillin prevalence rate of 32.0% (12.1-51.9%). Approximately 94.4% (90.7-98.1%) and 92.3% (87.4-97.3%) of isolates were resistant to erythromycin and clindamycin. eBURST analysis revealed great diversity among isolates, with 102 sequence types (STs) for 365 isolates. The major predominant clonal complexes (CCs) were CC271 (43.6%, 159/365), CC876 (13.4%, 49/365), CC81 (5.2%, 19/365), and CC90 (4.1%, 15/365). Long-term and regional surveillance of S. pneumoniae is necessary.
Conclusions:
Based on our pooled results showing that PCV13 coverage of the reported serotypes was 90% and that most serotypes contributed to the distribution of antibiotic-resistant isolates, implementation of PCV13 into the Chinese Expanded Program on Immunizations (EPI) would achieve health benefits in Chinese children.
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