Distribution of Streptococcus pneumoniae serotypes in the northeast macro-region of Sao Paulo state/Brazil after the introduction of conjugate vaccine

作者：Cazentini Medeiros Marta Ines; Grassi Almeida Samanta Cristine; Leopoldo Silva Guerra Maria Luiza; da Silva Paulo; Machado Carneiro Ana Maria; de Andrade Denise^*

来源：BMC Infectious Diseases, 2017, 17(1): 590.

DOI：10.1186/s12879-017-2696-y

• Streptococcus pneumoniae
• pneumococcus
• serotype
• conjugate vaccine

Background: Infections caused by Streptococcus pneumoniae (Spn) still challenge health systems around the world, even with advances in vaccination programs. The present study evaluated the frequency of various Spn serotypes isolated in Regional Health Care Network 13 (RRAS 13), which includes the regional health departments (RHDs) of Araraquara, Barretos, Franca and Ribeirao Preto, especially after the introduction of 10-valent pneumococcal conjugate vaccine (PCV10) in 2010.
Methods: The analyzed Spn strains were isolated from patients with invasive pneumococcal diseases (IPDs) and then sent to Adolfo Lutz Institute (ALI) for further confirmative identification tests during the period from 1998 to 2013. The samples were from the cities in RRAS13, which is located in the Northeast region of Sao Paulo State, and totals 90 municipalities.
Results: We analyzed strains isolated from 796 patients. They were predominantly: men (58.9%); 20 to 60 years old (32.2%); evaluated from 2003 to 2010 (60.2%); and diagnosed with meningitis (45.7%) and pneumonia (45.0%), the most common invasive pneumococcal diseases. In 2010, serotypes 3, 19F, 1, 23F, 6A and 6B were among the most frequent, while serotypes 3, 12F, 14, 6A, 18C, 8 and 6B were more common after the introduction of PCV10. Serotypes 14, 19F and 3 were more frequent in meningitis, while serotypes 14, 3 and 1 prevailed in pneumonia. After 2010, there was a decrease in serotypes 14, 1, 23F and 5 and an increase in serotypes 3, 12F, 11A and 8, which were not present in the vaccine.
Conclusions: The present study noted the increase in serotypes 3, 12F, 11A and 8 after vaccination. None of those serotypes are included in the available conjugate vaccines, which highlights the importance of continued monitoring of IPDs in order to measure the disease burden in the population in the long term and provide new epidemiological information to determine the impact of PCV10 in Brazil.

• 出版日期2017-8-25