Toraño-Peraza G, Pías-Solis L, Abreu-Capote M, Rodríguez-Ortega M, Dickinson-Meneses F, Varcárcel-Sánchez M

Language: Spanish
References: 18
Page: 117-123
PDF size: 112.00 Kb.

ABSTRACT

An observational study was conducted to know the serotypes and antimicrobial susceptibility of isolates of Streptococcus pneumoniae responsible for meningitis in Cuba, where there is no vaccine yet to prevent invasive pneumococcal disease. The study included the total number of isolates submitted to the "Pedro Kourí" Institute between 2007 and 2012 (N=237). Serotypes identification was performed using capsular swelling test and antimicrobial susceptibility was studied by determining the minimum inhibitory concentration using the broth microdilution method. Predominant serotypes were 6A, 6B, 14, 19F and 23F and other non-vaccinal 18 serogroups/serotypes were identified in 29.1% of the isolates. A tendency to an increased resistance to penicillin (44.3 %) was observed; the most common resistance patterns were: penicillin-trimethoprim/sulfamethoxazole and penicillin-erythromycin (21.1% and 10.5%, respectively). The largest number of isolates resistant to penicillin was in serotypes 6B, 14, 19F and 23F and the possibility of resistant non-vaccine serotypes emergence should be considered. The results show that 70.4 % of the isolates studied corresponds to the serotypes included in 13-valent conjugated pneumococcal vaccine, but with 10-valent it would achieve a lower vaccination potential coverage (56.1%). This information must be considered when evaluating the decision to use in Cuba any commercially available vaccine or the proposal of another strategy of vaccination from autochthonous vaccine candidates.

REFERENCES

1. World Weinberger D, Malley R, Lipsith M. Serotype replacement in disease after pneumococcal vaccination. Lancet 2011;378:1962-73.

2. Thomas J, Figueira M, Fennie K, Laufer A, Kong Y, Pichichero M. Streptococcus pneumoniae Clonal Complex 199: Genetic Diversity and Tissue-Specific Virulence. PLoS One 2011;6(4):e18649. Disponible en: doi:10.1371/journal.pone.0018649.

3. Pérez A, Dickinson F, Rodriguez M. Community acquired bacterial meningitis in Cuba: a follow up of a decade. BMC Infect Dis 2010;10(130):1-9.

4. Toraño G, Llanes R, Pías L, Abreu M, Varcárcel M. Serotipos de Streptococcus pneumoniae en Cuba y progresión de la resistencia a la penicilina. Rev Cubana Med Trop 2010;62(2):157-60.

5. Tamargo I, Llanes R, Toraño G, Hernández I, Pérez M, Llop A, et al. Informe Regional SIREVAII: Datos por país y por grupos de edad sobre las características de los aislamientos de Streptococcus pneumoniae, Haemophilus influenzae y Neisseria meningitidis, en procesos invasores, 2000-2005. Tecnologías Esenciales de Salud. THS/EV - 2007/002. Washington, D.C: OPS;2007.

6. Perilla MJ, Ajello G, Bopp C, Elliott J, Facklam R, Knapp J, et al. Manual de Laboratorio para la Identificación y Prueba de Susceptibilidad a los Antimicrobianos de patógenos Bacterianos de Importancia para la Salud Pública en el Mundo en Desarrollo. WHO/CDC/CSR/RMD/2003.6. Atlanta: WHO;2003.

7. Organización Panamericana de la Salud. Programa de vigilancia de los serotipos y resistencia antimicrobiana de Streptococcus pneumoniae y Haemophilus influenzae. Manual de procedimientos del proyecto SIREVA II. Washington, D.C: OPS;2012. Disponible en: http://wwwpahoorg/Spanish/AD/THS/EV/LABS-manualvigilancia- serotipospdf.

8. Clinical Laboratory Standard Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty- Second Informational Supplement. CLSI document M100- S22. Wayne: Clinical and Laboratory Standards Institute;2012.

9. Tamargo I, Llanes R, Toraño G, Hernández I, Pérez M, Llop A, et al. Informe Regional Sireva II, 2006: Datos por país y por grupos de edad sobre las características de los aislamientos de Streptococcus pneumoniae, Haemophilus influenzae y Neisseria meningitidis, en procesos invasores. Tecnologías Esenciales de Salud. THS/EV- 2008/001. Washington, D.C: OPS;2008.

10. Gabastou JM, Agudelo CI, Brandileone MC, Castañeda E, Silva de Lemos AP, Di Fabio JL. Caracterización de aislamientos invasivos de S. pneumoniae, H. influenzae y N meningitidis en América Latina y el Caribe: SIREVA II, 2000- 2005. Rev Panam Salud 2008;24(1):1-15.

11. Jacobs M, Good C, Bajaksouzian S, Windau A. Emergence of Streptococcus pneumoniae Serotypes 19A, 6C, and 22F and Serogroup 15 in Cleveland, Ohio, in Relation to Introduction of the Protein-Conjugated Pneumococcal Vaccine. Clin Infect Dis 2008;47(11):1388-95.

12. González BE, Hulten KG, Lamberth L, Kaplan SL, Mason EO. Pediatric Multicenter Pneumococcal Surveillance Group. Streptococcus pneumoniae serogroups 15 and 33: an increasing cause of pneumococcal infections in children in the United States after the introduction of the pneumococcal 7-valent conjugate vaccine. Pediatr Infect Dis J 2006;25(4):301-5.

13. Castañeda E, Agudelo C, Regueira M, Corso A, Brandileone MC, Brandao A, et al. Laboratory-Based Surveillance of Streptococcus pneumoniae Invasive Disease in Children in 10 Latin American Countries. SIREVA II Project, 2000-2005. Pediatric Infec Dis J 2009;28(9):265-70.

14. OMS. Vacunas antineumocócicas. Documento de posición de la OMS-2012. Boletín Epidemiológico Semanal 2012;87(4):129-44.

15. Al-Yaqoubi M, Elhag K. Serotype Prevalence and Penicillinsusceptibility of Streptococcus pneumoniae in Oman. Oman Med J 2011;26(1):43-7.

16. Manning L, Laman N, Greenhll A, Michael A, Siba P, Mueller I, et al. Increasing chloramphenicol resistance in Streptococcus pneumoniae isolates from Papua New Guinea children with acute bacterial meningitis. Antimicrob Agents Chemother 2011;55(9):4454-6.

17. García-Vera C. Estado de portador de neumococo en niños y su relación con la enfermedad invasiva. ¿Qué ha cambiado tras la introducción de la vacuna conjugada? Rev Pediatr Aten Primaria 2010;12:457-82.

18. Maducolil J, Mariya N, Ravi P, Purushothaman A, Acharya B, Shivananda PG. Streptococcus pneumoniae infections in Western Nepal. Southeast Asian J Trop Med Public Health 2011;42(4):912-9.