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Streptococcus pneumoniae serotype 19A in children, South Korea.

Choi EH, Kim SH, Eun BW, Kim SJ, Kim NH, Lee J, Lee HJ - Emerging Infect. Dis. (2008)

Bottom Line: Overall, the proportion of serotype 19A isolates increased but serotype 19F decreased.Among children <5 years of age, the proportion of serotype 19A isolates in invasive pneumococcal disease increased from 0% in 1991-1994 to 8%-10% in 1995-2000, reached 26% in 2001-2003, and remained at 20% in 2004-2006 when vaccine coverage did not exceed 25% (p = 0.005 for trend).This study demonstrates that the expansion of multidrug-resistant ST320 was responsible for the increase in serotype 19A before PCV7 use.

View Article: PubMed Central - PubMed

Affiliation: Seoul National University College of Medicine, Seoul, South Korea.

ABSTRACT
Despite the concern of replacement disease, notably by serotype 19A after 7-valent conjugate vaccine (PCV7) use, serotype 19A was increasingly recognized in Korean children before the introduction of PCV7. To understand the dynamics of serogroup 19 prevalence from 1991-2006, we serotyped 538 pediatric pneumococcal isolates. Serogroup 19 isolates (n = 126) were characterized by antimicrobial drug susceptibility, presence of mefA/ermB, and multilocus sequence typing. Overall, the proportion of serotype 19A isolates increased but serotype 19F decreased. Among children <5 years of age, the proportion of serotype 19A isolates in invasive pneumococcal disease increased from 0% in 1991-1994 to 8%-10% in 1995-2000, reached 26% in 2001-2003, and remained at 20% in 2004-2006 when vaccine coverage did not exceed 25% (p = 0.005 for trend). This study demonstrates that the expansion of multidrug-resistant ST320 was responsible for the increase in serotype 19A before PCV7 use.

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Related in: MedlinePlus

Distribution of serotypes with regard to 7-valent conjugate vaccine (PCV7) among 107 pneumococci isolated from children <5 years of age with an invasive pneumococcal infection (IPD) during five 3- or 4-year periods from 1991 through 2006, South Korea. *The observed increase in the proportion of 19A (p = 0.005) and decrease in the proportion of 19F (p = 0.008) among invasive isolates were statistically significant.
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Figure 2: Distribution of serotypes with regard to 7-valent conjugate vaccine (PCV7) among 107 pneumococci isolated from children <5 years of age with an invasive pneumococcal infection (IPD) during five 3- or 4-year periods from 1991 through 2006, South Korea. *The observed increase in the proportion of 19A (p = 0.005) and decrease in the proportion of 19F (p = 0.008) among invasive isolates were statistically significant.

Mentions: Among the 107 invasive isolates from children <5 years of age (Figure 2), serotype 19F decreased from 31% (8/26) in period 1 to 13% (3/24) in period 2 and to 5% (1/20) in periods 3 and 4 (p = 0.008 for trend). The proportion of 19A increased from 0% (0/26) in period 1 to 8% (2/24) in period 2 and reached 26% (7/27) in period 4 (p = 0.005 for trend). There were no significant trends for the remaining serotypes: 23F (p = 0.58), 14 (p = 0.28), 9V (p = 0.23), 6A (p = 0.38), and 6B (p = 0.23). During period 5, after vaccine introduction, the proportion of 19A isolates was 20% (2/10). During 2001–2003, 19A was the most common serotype among IPD isolates from South Korean children <5 years of age. During 2004–2006, the postvaccine period, when PCV7 uptake reached ≈20%–25% of South Korean children <2 years of age (21), the distribution of serotypes was unaltered compared with distribution during the prevaccine 2001–2003 period. There was no major change in antimicrobial drug treatment policy or pressure to use antimicrobial drugs in the local pediatric practice during the study period.


Streptococcus pneumoniae serotype 19A in children, South Korea.

Choi EH, Kim SH, Eun BW, Kim SJ, Kim NH, Lee J, Lee HJ - Emerging Infect. Dis. (2008)

Distribution of serotypes with regard to 7-valent conjugate vaccine (PCV7) among 107 pneumococci isolated from children <5 years of age with an invasive pneumococcal infection (IPD) during five 3- or 4-year periods from 1991 through 2006, South Korea. *The observed increase in the proportion of 19A (p = 0.005) and decrease in the proportion of 19F (p = 0.008) among invasive isolates were statistically significant.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600206&req=5

Figure 2: Distribution of serotypes with regard to 7-valent conjugate vaccine (PCV7) among 107 pneumococci isolated from children <5 years of age with an invasive pneumococcal infection (IPD) during five 3- or 4-year periods from 1991 through 2006, South Korea. *The observed increase in the proportion of 19A (p = 0.005) and decrease in the proportion of 19F (p = 0.008) among invasive isolates were statistically significant.
Mentions: Among the 107 invasive isolates from children <5 years of age (Figure 2), serotype 19F decreased from 31% (8/26) in period 1 to 13% (3/24) in period 2 and to 5% (1/20) in periods 3 and 4 (p = 0.008 for trend). The proportion of 19A increased from 0% (0/26) in period 1 to 8% (2/24) in period 2 and reached 26% (7/27) in period 4 (p = 0.005 for trend). There were no significant trends for the remaining serotypes: 23F (p = 0.58), 14 (p = 0.28), 9V (p = 0.23), 6A (p = 0.38), and 6B (p = 0.23). During period 5, after vaccine introduction, the proportion of 19A isolates was 20% (2/10). During 2001–2003, 19A was the most common serotype among IPD isolates from South Korean children <5 years of age. During 2004–2006, the postvaccine period, when PCV7 uptake reached ≈20%–25% of South Korean children <2 years of age (21), the distribution of serotypes was unaltered compared with distribution during the prevaccine 2001–2003 period. There was no major change in antimicrobial drug treatment policy or pressure to use antimicrobial drugs in the local pediatric practice during the study period.

Bottom Line: Overall, the proportion of serotype 19A isolates increased but serotype 19F decreased.Among children <5 years of age, the proportion of serotype 19A isolates in invasive pneumococcal disease increased from 0% in 1991-1994 to 8%-10% in 1995-2000, reached 26% in 2001-2003, and remained at 20% in 2004-2006 when vaccine coverage did not exceed 25% (p = 0.005 for trend).This study demonstrates that the expansion of multidrug-resistant ST320 was responsible for the increase in serotype 19A before PCV7 use.

View Article: PubMed Central - PubMed

Affiliation: Seoul National University College of Medicine, Seoul, South Korea.

ABSTRACT
Despite the concern of replacement disease, notably by serotype 19A after 7-valent conjugate vaccine (PCV7) use, serotype 19A was increasingly recognized in Korean children before the introduction of PCV7. To understand the dynamics of serogroup 19 prevalence from 1991-2006, we serotyped 538 pediatric pneumococcal isolates. Serogroup 19 isolates (n = 126) were characterized by antimicrobial drug susceptibility, presence of mefA/ermB, and multilocus sequence typing. Overall, the proportion of serotype 19A isolates increased but serotype 19F decreased. Among children <5 years of age, the proportion of serotype 19A isolates in invasive pneumococcal disease increased from 0% in 1991-1994 to 8%-10% in 1995-2000, reached 26% in 2001-2003, and remained at 20% in 2004-2006 when vaccine coverage did not exceed 25% (p = 0.005 for trend). This study demonstrates that the expansion of multidrug-resistant ST320 was responsible for the increase in serotype 19A before PCV7 use.

Show MeSH
Related in: MedlinePlus