Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/13824
Title: Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil
Authors: Santos, Milena Soares dos
Azevedo, Jailton
Menezes, Ana Paula de Oliveira
Cordeiro, Soraia Machado
Escobar, Eliane Cunegundes
Lima, Josilene Borges T
Campos, Leila Carvalho
Carvalho, Maria da Gloria S
Reis, Mitermayer Galvão dos
Ko, Albert Icksang
Reis, Joice Neves
Affilliation: Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Estadual do Sudoeste da Bahia. Jequié, BA, Brasil
Universidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Universidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Centers for Disease Control and Prevention. Streptococcus Laboratory. Atlanta, GA, USA
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, USA
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, Brasil
Abstract: BACKGROUND: Hospital-based surveillance for pneumococcal meningitis has been conducted since January 1996 in the city of Salvador, Brazil. The purpose of this study was to describe the temporal evolution of Penicillin Non-Susceptible Streptococcus pneumoniae (PNSSP) in regards to serotype distributions and clonal diversity recovered from meningitis cases over 17 years. METHODS: Broth microdilution was used to identify pneumococcal isolates that were PNSSP (Minimum Inhibitory Concentration > 0.12 µg/ml). The annual incidence rate of meningitis cases was calculated. Serotyping was defined using multiplex polymerase chain reaction assays and quellung reaction. Genetic diversity of PNSSP isolates was assessed using both pulsed-field gel electrophoresis (PFGE) and Multilocus Sequence Typing (MLST) analyses. RESULTS: A total of 854 cerebrospinal fluid (CSF) culture pneumococcal isolates were tested by broth microdilution method and serotyped. A total of 173 (20.3%) were penicillin non-susceptible (PNSSP) (Minimum Inhibitory concentration ≥ 0.12 µg/ml). The annual incidence of meningitis cases declined from 1.65/100,000 population (1996) to 0.2/100,000 population in 2012 and the rate due to PNSSP declined 82% over the 17-years of surveillance. PNSSP isolates were restricted to 13 serotypes, being the most common ones serotypes 14 (45.1%; 78/173), 23 F (19.1%; 33/173), 6B (14.4%; 25/173), 19 F (9.2%; 16/173) and 19A (5.2%; 9/173). Among the PNSSP isolates, 94% had serotypes represented in the 10-valent conjugate vaccine (PCV10). The predominant serotype 14 clonal groups were identified as PFGE group A/multilocus sequence type 66 (ST66) [35.3% (61/173)] and PFGE group GK/ST156 [4.6% (8/173)], the latter one associated with high level resistance to penicillin and ceftriaxone. CONCLUSIONS: Our results show sustained reductions in pneumococcal meningitis cases in the Metropolitan region of Salvador from 1996 to 2012. This might reflect a beneficial impact of conjugate vaccines. Continued surveillance and further studies need to be conducted to better understanding on PCV10 vaccine impact.
Keywords: Streptococcus pneumoniae
Antibiotic resistance
Genotype
Surveillance
DeCS: Meningite Pneumocócica/epidemiologia
Meningite Pneumocócica/microbiologia
Resistência às Penicilinas
Streptococcus pneumoniae/classificação
Variação Antigênica
Técnicas de Tipagem Bacteriana/métodos
Brasil/epidemiologia
Ceftriaxona/uso terapêutico
Criança
Pré-escolar
Feminino
Variação Genética
Humanos
Incidência
Lactente
Masculino
Meningite Pneumocócica/quimioterapia
Reação em Cadeia da Polimerase Multiplex
Penicilina G/uso terapêutico
Resistência às Penicilinas/genética
Vacinas Pneumocócicas/uso terapêutico
Sorotipagem
Issue Date: 2015
Publisher: Elsevier
Citation: SANTOS, M. S. dos et al. Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil. BMC Infectious Diseases, v. 15, p. 302, 2015.
DOI: 10.1186/s12879-015-1049-y
ISSN: 1471-2334
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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