Phenotypic and genotypic characteristic of invasive pneumococcal isolates from both children and adult patients from a multicenter surveillance in China 2005-2011

PLoS One. 2013 Dec 11;8(12):e82361. doi: 10.1371/journal.pone.0082361. eCollection 2013.

Abstract

Streptococcus pneumoniae is an important pathogen in both children and the elderly, but previous studies in China have provided limited information about invasive pneumococcal disease (IPD). A total of 240 IPD S. pneumoniae strains (from 105 children and 135 adults) were collected from 12 cities in China in 2005-2011. Their phenotypes and genetic characteristics were analyzed. Streptococcus pneumoniae remained highly resistant to macrolides, tetracycline, and cotrimoxazole each year. Serotypes were assigned to the 240 isolates, and 19A (22.1%), 19F (21.7%), 14 (7.5%), 3 (7.1%), and 23F (5.4%) were the most prevalent, accounting for 63.8% of all strains. Serogroup 19 strains were significantly more common among children than among adults (58.7% vs 32.4%, respectively; P < 0.001). Serotypes 19F and 19A demonstrated higher resistance to β-lactams and cephalosporins than the other serotypes. The coverage of PCV13 was superior to that calculated for PCV7 and PCV10 (77.9% vs 40.8% and 47.1%, respectively), and coverage was higher in children than in adults (85.6% vs 72.1%, respectively; P = 0.012). A multilocus sequence typing analysis revealed great diversity, with nine clonal complexes and 83 singletons among all the strains. Specifically, CC271 was more common in children, whereas singletons were more prevalent in adults. Among the serogroup 19 strains, 84.7% were ST271, ST320, or ST236, belonging to CC271. The homogeneous genetic background of 19F and 19A, together with the high resistance of these strains, suggests that clonal spread is responsible for the high prevalence of serogroup 19 in IPD. This is the first large study to investigate IPD strains in both children and adults in China.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Anti-Bacterial Agents / pharmacology
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cities
  • Drug Resistance, Bacterial / drug effects
  • Genotype
  • Humans
  • Infant
  • Microbial Sensitivity Tests
  • Middle Aged
  • Multicenter Studies as Topic*
  • Multilocus Sequence Typing
  • Phenotype
  • Pneumococcal Infections / epidemiology
  • Pneumococcal Infections / immunology
  • Pneumococcal Infections / microbiology
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / immunology
  • Population Surveillance*
  • Serotyping
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / genetics*
  • Streptococcus pneumoniae / isolation & purification*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Pneumococcal Vaccines

Grants and funding

This study was partially supported by GPRS project of Sanofi-Aventis, Pharmaceuticals Co., Ltd., for collection of Streptococcus pneumoniae strains and no additional external funding was received for this study. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.