Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Dallas, TX, children from 1999 through 2005

Because the heptavalent pneumococcal conjugate vaccine has reduced vaccine-type invasive pneumococcal disease (IPD) in children, a greater proportion of IPD is now caused by nonvaccine (NVT) serotypes. We analyzed the serotypes, antimicrobial resistance profiles and genetic relatedness of Streptococ...

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Veröffentlicht in:The Pediatric infectious disease journal 2007-06, Vol.26 (6), p.461-467
Hauptverfasser: MESSINA, Allison F, KATZ-GAYNOR, Kathy, BARTON, Theresa, AHMAD, Naveed, GHAFFAR, Faryal, RASKO, David, MCCRACKEN, George H
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container_end_page 467
container_issue 6
container_start_page 461
container_title The Pediatric infectious disease journal
container_volume 26
creator MESSINA, Allison F
KATZ-GAYNOR, Kathy
BARTON, Theresa
AHMAD, Naveed
GHAFFAR, Faryal
RASKO, David
MCCRACKEN, George H
description Because the heptavalent pneumococcal conjugate vaccine has reduced vaccine-type invasive pneumococcal disease (IPD) in children, a greater proportion of IPD is now caused by nonvaccine (NVT) serotypes. We analyzed the serotypes, antimicrobial resistance profiles and genetic relatedness of Streptococcus pneumoniae responsible for IPD at Children's Medical Center of Dallas. S. pneumoniae isolates were collected from January 1, 1999 through December 31, 2005. Incidence of IPD was calculated using inpatient and emergency center admissions to Children's Medical Center of Dallas as the denominator. Isolates were serotyped, and their penicillin and cefotaxime susceptibility determined. The 19A isolates were further characterized by pulsed-field gel electrophoresis, multilocus sequence typing and determination of penicillin-binding proteins and mef and erm genes. The incidence of IPD decreased from 93.6 cases/100,000 patients in 1999 to a nadir of 41 cases/100,000 patients in 2003 (P < 0.001). The number of IPD cases caused by serotype 19A increased, accounting for 40% of the cases of IPD in 2005. Penicillin and cefotaxime susceptibility of IPD isolates did not change from 1999 through 2005 (P = 0.687). There was a decrease in penicillin (P < 0.001) and cefotaxime (P = 0.034) susceptibility in NVT serotypes from 1999 to 2005. Molecular characterization of 19A isolates revealed a predominance of ST-199 (62%). Several highly penicillin-resistant and intermediately cefotaxime-resistant strains emerged in 2004 and 2005. In Dallas, heptavalent pneumococcal conjugate vaccine reduced the incidence of IPD from 1999 to 2005 by reducing the incidence of vaccine-type disease. NVT serotypes, particularly 19A, were prevalent and more resistant to antimicrobials in 2004 and 2005.
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We analyzed the serotypes, antimicrobial resistance profiles and genetic relatedness of Streptococcus pneumoniae responsible for IPD at Children's Medical Center of Dallas. S. pneumoniae isolates were collected from January 1, 1999 through December 31, 2005. Incidence of IPD was calculated using inpatient and emergency center admissions to Children's Medical Center of Dallas as the denominator. Isolates were serotyped, and their penicillin and cefotaxime susceptibility determined. The 19A isolates were further characterized by pulsed-field gel electrophoresis, multilocus sequence typing and determination of penicillin-binding proteins and mef and erm genes. The incidence of IPD decreased from 93.6 cases/100,000 patients in 1999 to a nadir of 41 cases/100,000 patients in 2003 (P &lt; 0.001). The number of IPD cases caused by serotype 19A increased, accounting for 40% of the cases of IPD in 2005. Penicillin and cefotaxime susceptibility of IPD isolates did not change from 1999 through 2005 (P = 0.687). There was a decrease in penicillin (P &lt; 0.001) and cefotaxime (P = 0.034) susceptibility in NVT serotypes from 1999 to 2005. Molecular characterization of 19A isolates revealed a predominance of ST-199 (62%). Several highly penicillin-resistant and intermediately cefotaxime-resistant strains emerged in 2004 and 2005. In Dallas, heptavalent pneumococcal conjugate vaccine reduced the incidence of IPD from 1999 to 2005 by reducing the incidence of vaccine-type disease. 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Drug treatments</topic><topic>Pneumococcal Infections - epidemiology</topic><topic>Pneumococcal Infections - immunology</topic><topic>Pneumococcal Infections - microbiology</topic><topic>Pneumococcal Vaccines - immunology</topic><topic>Serotyping</topic><topic>Staphylococcal infections, streptococcal infections, pneumococcal infections</topic><topic>Streptococcus pneumoniae - classification</topic><topic>Streptococcus pneumoniae - drug effects</topic><topic>Streptococcus pneumoniae - immunology</topic><topic>Streptococcus pneumoniae - isolation &amp; purification</topic><topic>Texas - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MESSINA, Allison F</creatorcontrib><creatorcontrib>KATZ-GAYNOR, Kathy</creatorcontrib><creatorcontrib>BARTON, Theresa</creatorcontrib><creatorcontrib>AHMAD, Naveed</creatorcontrib><creatorcontrib>GHAFFAR, Faryal</creatorcontrib><creatorcontrib>RASKO, David</creatorcontrib><creatorcontrib>MCCRACKEN, George H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MESSINA, Allison F</au><au>KATZ-GAYNOR, Kathy</au><au>BARTON, Theresa</au><au>AHMAD, Naveed</au><au>GHAFFAR, Faryal</au><au>RASKO, David</au><au>MCCRACKEN, George H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Dallas, TX, children from 1999 through 2005</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2007-06-01</date><risdate>2007</risdate><volume>26</volume><issue>6</issue><spage>461</spage><epage>467</epage><pages>461-467</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><coden>PIDJEV</coden><abstract>Because the heptavalent pneumococcal conjugate vaccine has reduced vaccine-type invasive pneumococcal disease (IPD) in children, a greater proportion of IPD is now caused by nonvaccine (NVT) serotypes. We analyzed the serotypes, antimicrobial resistance profiles and genetic relatedness of Streptococcus pneumoniae responsible for IPD at Children's Medical Center of Dallas. S. pneumoniae isolates were collected from January 1, 1999 through December 31, 2005. Incidence of IPD was calculated using inpatient and emergency center admissions to Children's Medical Center of Dallas as the denominator. Isolates were serotyped, and their penicillin and cefotaxime susceptibility determined. The 19A isolates were further characterized by pulsed-field gel electrophoresis, multilocus sequence typing and determination of penicillin-binding proteins and mef and erm genes. The incidence of IPD decreased from 93.6 cases/100,000 patients in 1999 to a nadir of 41 cases/100,000 patients in 2003 (P &lt; 0.001). The number of IPD cases caused by serotype 19A increased, accounting for 40% of the cases of IPD in 2005. Penicillin and cefotaxime susceptibility of IPD isolates did not change from 1999 through 2005 (P = 0.687). There was a decrease in penicillin (P &lt; 0.001) and cefotaxime (P = 0.034) susceptibility in NVT serotypes from 1999 to 2005. Molecular characterization of 19A isolates revealed a predominance of ST-199 (62%). Several highly penicillin-resistant and intermediately cefotaxime-resistant strains emerged in 2004 and 2005. In Dallas, heptavalent pneumococcal conjugate vaccine reduced the incidence of IPD from 1999 to 2005 by reducing the incidence of vaccine-type disease. NVT serotypes, particularly 19A, were prevalent and more resistant to antimicrobials in 2004 and 2005.</abstract><cop>Baltimore, MD</cop><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>17529859</pmid><doi>10.1097/INF.0b013e31805cdbeb</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
Anti-Bacterial Agents - pharmacology
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial diseases
Bacterial Proteins - genetics
Biological and medical sciences
Cefotaxime - pharmacology
Child
Child, Preschool
DNA Fingerprinting
DNA, Bacterial - chemistry
DNA, Bacterial - genetics
Drug Resistance, Bacterial
Electrophoresis, Gel, Pulsed-Field
Female
Heptavalent Pneumococcal Conjugate Vaccine
Human bacterial diseases
Humans
Incidence
Infant
Infectious diseases
Male
Medical sciences
Membrane Proteins - genetics
Meningococcal Vaccines - immunology
Methyltransferases - genetics
Microbial Sensitivity Tests
Penicillins - pharmacology
Pharmacology. Drug treatments
Pneumococcal Infections - epidemiology
Pneumococcal Infections - immunology
Pneumococcal Infections - microbiology
Pneumococcal Vaccines - immunology
Serotyping
Staphylococcal infections, streptococcal infections, pneumococcal infections
Streptococcus pneumoniae - classification
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - immunology
Streptococcus pneumoniae - isolation & purification
Texas - epidemiology
title Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Dallas, TX, children from 1999 through 2005
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