1887

Abstract

In Japan, the 7-valent pneumococcal vaccine (PCV7) was introduced in 2010 and, in 2013, the PCV7 was replaced with the 13-valent pneumococcal vaccine (PCV13). This study was conducted to investigate serotypes, antimicrobial resistance and prevalence of pilus islets in pneumococcal isolates from inpatients in a Japanese tertiary hospital.

From April 2011 to February 2016, 151 isolates [95 (18 children, 77 adults) and 56 (19 children, 37 adults) in the PCV7 and PCV13 periods, respectively] were collected. All isolates were serotyped using genetic methods and were tested for susceptibility to 18 antimicrobials. Unaltered penicillin-binding protein (PBP) genes, macrolide resistance genes and pilus islets were identified by PCR.

Between the two periods, the prevalence of non-PCV13 serotypes was shown to increase from 50.0 to 78.9 % in children, and serotype 3 increased from 14.3 to 24.3 % in adults. Six of seven isolates from invasive diseases were assigned to non-PCV13 serotypes. Overall, multidrug resistance (MDR) was detected in 46.4 % of isolates, which included the dominant non-PCV13 serotypes 6E, 15A and 23A (prevalence≥75.0 %). gPRSP (three altered genes , and ) and macrolide resistance genes [(B) and/or (A/E)] were detected in 35.8 and 93.4 % of all isolates, respectively. Pilus islets [PI-1 (clade I, II and III) and/or PI-2] were found in 22.5 % (34/151) of isolates belonging to six different serotypes (19F, 23F, 19A, 6E, 15B and 35B) and 88.2 % (30/34) of these exhibited MDR.

This study revealed the spread of MDR in several non-PCV13 serotypes and in isolates with pilus islets.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000479
2017-05-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/66/5/643.html?itemId=/content/journal/jmm/10.1099/jmm.0.000479&mimeType=html&fmt=ahah

References

  1. Bentley SD, Aanensen DM, Mavroidi A, Saunders D, Rabbinowitsch E et al. Genetic analysis of the capsular biosynthetic locus from all 90 pneumococcal serotypes. PLoS Genet 2006; 2:e31 [View Article][PubMed]
    [Google Scholar]
  2. van Tonder AJ, Bray JE, Roalfe L, White R, Zancolli M et al. Genomics reveals the worldwide distribution of multidrug-resistant serotype 6E pneumococci. J Clin Microbiol 2015; 53:2271–2285 [View Article][PubMed]
    [Google Scholar]
  3. Ubukata K, Chiba N, Hanada S, Morozumi M, Wajima T et al. Serotype changes and drug resistance in invasive pneumococcal diseases in adults after vaccinations in children, Japan, 2010–2013. Emerg Infect Dis 2015; 21:1956–1965 [View Article][PubMed]
    [Google Scholar]
  4. Richter SS, Heilmann KP, Dohrn CL, Riahi F, Diekema DJ et al. Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999–2011. Emerg Infect Dis 2013; 19:1074–1083 [View Article][PubMed]
    [Google Scholar]
  5. Richter SS, Diekema DJ, Heilmann KP, Dohrn CL, Riahi F et al. Changes in pneumococcal serotypes and antimicrobial resistance after introduction of the 13-valent conjugate vaccine in the United States. Antimicrob Agents Chemother 2014; 58:6484–6489 [View Article][PubMed]
    [Google Scholar]
  6. Janoir C, Lepoutre A, Gutmann L, Varon E. Insight into resistance phenotypes of emergent non 13-valent pneumococcal conjugate vaccine type pneumococci isolated from invasive disease after 13-valent pneumococcal conjugate vaccine implementation in France. Open Forum Infect Dis 2016; 3:ofw020 [View Article][PubMed]
    [Google Scholar]
  7. Nunes S, Félix S, Valente C, Simões AS, Tavares DA et al. The impact of private use of PCV7 in 2009 and 2010 on serotypes and antimicrobial resistance of Streptococcus pneumoniae carried by young children in Portugal: comparison with data obtained since 1996 generating a 15-year study prior to PCV13 introduction. Vaccine 2016; 34:1648–1656 [View Article][PubMed]
    [Google Scholar]
  8. Chan KC, Subramanian R, Chong P, Nelson EA, Lam HS et al. Pneumococcal carriage in young children after introduction of PCV13 in Hong Kong. Vaccine 2016; 34:3867–3874 [View Article][PubMed]
    [Google Scholar]
  9. Barocchi MA, Ries J, Zogaj X, Hemsley C, Albiger B et al. A pneumococcal pilus influences virulence and host inflammatory responses. Proc Natl Acad Sci USA 2006; 103:2857–2862 [View Article][PubMed]
    [Google Scholar]
  10. Regev-Yochay G, Hanage WP, Trzcinski K, Rifas-Shiman SL, Lee G et al. Re-emergence of the type 1 pilus among Streptococcus pneumoniae isolates in Massachusetts, USA. Vaccine 2010; 28:4842–4846 [View Article][PubMed]
    [Google Scholar]
  11. Regev-Yochay G, Jaber H, Hamdan A, Daana M, Nammouz H et al. Vaccine escape of piliated Streptococcus pneumoniae strains. Vaccine 2016; 34:2787–2792 [View Article][PubMed]
    [Google Scholar]
  12. Bagnoli F, Moschioni M, Donati C, Dimitrovska V, Ferlenghi I et al. A second pilus type in Streptococcus pneumoniae is prevalent in emerging serotypes and mediates adhesion to host cells. J Bacteriol 2008; 190:5480–5492 [View Article][PubMed]
    [Google Scholar]
  13. Moschioni M, Donati C, Muzzi A, Masignani V, Censini S et al. Streptococcus pneumoniae contains 3 rlrA pilus variants that are clonally related. J Infect Dis 2008; 197:888–896 [View Article][PubMed]
    [Google Scholar]
  14. Selva L, Ciruela P, Blanchette K, del Amo E, Pallares R et al. Prevalence and clonal distribution of pcpA, psrP and pilus-1 among pediatric isolates of Streptococcus pneumoniae. PLoS One 2012; 7:e41587 [View Article][PubMed]
    [Google Scholar]
  15. Zähner D, Gudlavalleti A, Stephens DS. Increase in pilus islet 2-encoded pili among Streptococcus pneumoniae isolates, Atlanta, Georgia, USA. Emerg Infect Dis 2010; 16:955–962 [View Article][PubMed]
    [Google Scholar]
  16. Hjálmarsdóttir , Pétursdóttir B, Erlendsdóttir H, Haraldsson G, Kristinsson KG. Prevalence of pilus genes in pneumococci isolated from healthy preschool children in Iceland: association with vaccine serotypes and antibiotic resistance. J Antimicrob Chemother 2015; 70:2203–2208 [View Article][PubMed]
    [Google Scholar]
  17. Kawaguchiya M, Urushibara N, Aung MS, Morimoto S, Ito M et al. Emerging non-PCV13 serotypes of noninvasive Streptococcus pneumoniae with macrolide resistance genes in northern Japan. New Microbes New Infect 2016; 9:66–72 [View Article][PubMed]
    [Google Scholar]
  18. Tanaka J, Ishiwada N, Wada A, Chang B, Hishiki H et al. Incidence of childhood pneumonia and serotype and sequence-type distribution in Streptococcus pneumoniae isolates in Japan. Epidemiol Infect 2012; 140:1111–1121 [View Article][PubMed]
    [Google Scholar]
  19. van der Linden M, Falkenhorst G, Perniciaro S, Imöhl M. Effects of infant pneumococcal conjugate vaccination on serotype distribution in invasive pneumococcal disease among children and adults in Germany. PLoS One 2015; 10:e0131494 [View Article][PubMed]
    [Google Scholar]
  20. Pai R, Gertz RE, Beall B. Sequential multiplex PCR approach for determining capsular serotypes of Streptococcus pneumoniae isolates. J Clin Microbiol 2006; 44:124–131 [View Article][PubMed]
    [Google Scholar]
  21. Centers for Disease Control and Prevention 2016; PCR deduction of pneumococcal serotypes. www.cdc.gov/streplab/pcr.html [accesed 08 November 2015]
  22. Kawaguchiya M, Urushibara N, Ghosh S, Kuwahara O, Morimoto S et al. Serotype distribution and susceptibility to penicillin and erythromycin among noninvasive or colonization isolates of Streptococcus pneumoniae in northern Japan: a cross-sectional study in the pre-PCV7 routine immunization period. Microb Drug Resist 2014; 20:456–465 [View Article][PubMed]
    [Google Scholar]
  23. Kawaguchiya M, Urushibara N, Kobayashi N. High prevalence of genotype 6E (putative serotype 6E) among noninvasive/colonization isolates of Streptococcus pneumoniae in Northern Japan. Microb Drug Resist 2015; 21:209–214 [View Article][PubMed]
    [Google Scholar]
  24. Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement M100-S24 Wayne, PA, USA: CLSI; 2014
    [Google Scholar]
  25. European Committee on Antimicrobial Susceptibility Testing 2016; Breakpoint tables for interpretation of MICs and zone diameters version 6.0. EUCAST, 2016. www.eucast.org/clinical_breakpoints/
  26. Nagai K, Shibasaki Y, Hasegawa K, Davies TA, Jacobs MR et al. Evaluation of PCR primers to screen for Streptococcus pneumoniae isolates and beta-lactam resistance, and to detect common macrolide resistance determinants. J Antimicrob Chemother 2001; 48:915–918 [View Article][PubMed]
    [Google Scholar]
  27. Klaassen CH, Mouton JW. Molecular detection of the macrolide efflux gene: to discriminate or not to discriminate between mef(A) and mef(E). Antimicrob Agents Chemother 2005; 49:1271–1278 [View Article][PubMed]
    [Google Scholar]
  28. Ubukata K, Chiba N, Hasegawa K, Kobayashi R, Iwata S et al. Antibiotic susceptibility in relation to penicillin-binding protein genes and serotype distribution of Streptococcus pneumoniae strains responsible for meningitis in Japan, 1999 to 2002. Antimicrob Agents Chemother 2004; 48:1488–1494 [View Article]
    [Google Scholar]
  29. Choe YJ, Lee HJ, Lee H, Oh CE, Cho EY et al. Emergence of antibiotic-resistant non-vaccine serotype pneumococci in nasopharyngeal carriage in children after the use of extended-valency pneumococcal conjugate vaccines in Korea. Vaccine 2016; 34:4771–4776 [View Article]
    [Google Scholar]
  30. Chiba N, Morozumi M, Shouji M, Wajima T, Iwata S et al. Changes in capsule and drug resistance of pneumococci after introduction of PCV7, Japan, 2010–2013. Emerg Infect Dis 2014; 20:1132–1139 [View Article]
    [Google Scholar]
  31. Kawaguchiya M, Urushibara N, Kobayashi N. Multidrug resistance in non-PCV13 serotypes of Streptococcus pneumoniae in Northern Japan, 2014. Microb Drug Resist 2016
    [Google Scholar]
  32. Mendes RE, Hollingsworth RC, Costello A, Jones RN, Isturiz RE et al. Noninvasive Streptococcus pneumoniae serotypes recovered from hospitalized adult patients in the United States in 2009 to 2012. Antimicrob Agents Chemother 2015; 59:5595–5601 [View Article]
    [Google Scholar]
  33. Wierzbowski AK, Karlowsky JA, Adam HJ, Nichol KA, Hoban DJ et al. Evolution and molecular characterization of macrolide-resistant Streptococcus pneumoniae in Canada between 1998 and 2008. J Antimicrob Chemother 2014; 69:59–66 [View Article][PubMed]
    [Google Scholar]
  34. Del Grosso M, Camilli R, D'Ambrosio F, Petrucci G, Melchiorre S et al. Increase of pneumococcal serotype 19A in Italy is due to expansion of the piliated clone ST416/CC199. J Med Microbiol 2013; 62:1220–1225 [View Article]
    [Google Scholar]
  35. Aguiar SI, Melo-Cristino J, Ramirez M. Use of the 13-valent conjugate vaccine has the potential to eliminate pilus carrying isolates as causes of invasive pneumococcal disease. Vaccine 2012; 30:5487–5490 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000479
Loading
/content/journal/jmm/10.1099/jmm.0.000479
Loading

Data & Media loading...

Supplements

Supplementary File 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error