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  • Title: Emergence of invasive pneumococcal disease caused by multidrug-resistant serotype 19A among children in Barcelona.
    Author: Muñoz-Almagro C, Esteva C, de Sevilla MF, Selva L, Gene A, Pallares R.
    Journal: J Infect; 2009 Aug; 59(2):75-82. PubMed ID: 19576637.
    Abstract:
    OBJECTIVE: To describe the epidemiology of invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae serotype 19A. METHODS: We studied all children and adolescents with IPD caused by serotype 19A who were admitted to a Children's Hospital in Barcelona (1997-2007). Serotyping, antibiotic susceptibility and clonal analysis were performed. RESULTS: Comparing the pre-vaccine period (1997-2001) with the early vaccine period (2002-2004) and the late vaccine period (2005-2007) there was an increase of IPD caused by serotype 19A: 1 of 58 episodes (1.7%) vs. 8 of 54 episodes (14.8%) vs. 27 of 123 episodes (21.9%), respectively (P = 0.002). All S. pneumoniae serotype 19A isolated in the pre-vaccine and early vaccine periods (n = 9) were penicillin susceptible, while in the late vaccine period, 12 of 27 (44%) were penicillin nonsusceptible (P = 0.01). A clonal analysis revealed 15 different sequence types (STs) expressing serotype 19A. 10 of them were preexisting STs associated with serotype 19A including the multidrug-resistant ST320 and ST276. CONCLUSION: There was an increase of IPD caused by S. pneumoniae serotype 19A which was mainly related with the emergence of preexisting clones several of them closely related with international multidrug-resistant clones. These results should be considered when selecting the new conjugate pneumococcal vaccines.
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