title: Distribution of capsular types and antimicrobial susceptibility of invasive isolates of Streptococcus pneumoniae in Colombian children. Pneumococcal Study Group in Colombia.
abstract: Streptococcus pneumoniae is the leading bacterial cause of childhood pneumonia in the developing world. This study describes the type distribution and antimicrobial susceptibility of invasive pneumococcal isolates from Colombian children and is part of the Sistema Regional de Vacunas (SIREVA), a PAHO regional initiative designed to determine the ideal serotype composition of a protein polysaccharide pneumococcal conjugate vaccine for use in children less than 5 years old in Latin America. In Colombia, during the study period, centres in Bogota, Medellin, and Cali collected 324 S. pneumoniae isolates from invasive diseases, 238 (73.5%) from children under the age of 2. Pneumonia was the clinical diagnosis in 41.3% cases, meningitis in 41%, and sepsis in 11.2%. The seven most frequent types included 14(21.9%), 5(10.5%), 23F(9.6%), 1(9%), 6B(9%), 19F(7.1%), and 6A(6.2%). The frequency of diminished susceptibility to penicillin (DSP) was 12%, with 8.9% of isolates showing intermediate level resistance and 3.1% showing high level resistance. Among DSP isolates, 23% were also resistant to cefotaxime, 33.3% to erythromycin, 48.7% to chloramphenicol, and 74.3% to trimethoprim/sulfamethoxazole. Multiple resistance was detected in 59% of the isolates that have DSP. Penicillin resistance was associated with types 23F (53.8%) and 14 (25.6%). These data provides information on capsular types prevalent in Colombia that will not only allow the formulation of an ideal vaccine for the region but also reinforce the need for ongoing regional surveillance.
authors.affiliation: Instituto Nacional de Salud, Colombia.
authors.forename: E
authors.initials: E
authors.lastname: Castañeda
authors.forename: A L
authors.initials: AL
authors.lastname: Leal
authors.forename: O
authors.initials: O
authors.lastname: Castillo
authors.forename: F
authors.initials: F
authors.lastname: De La Hoz
authors.forename: M C
authors.initials: MC
authors.lastname: Vela
authors.forename: M
authors.initials: M
authors.lastname: Arango
authors.forename: H
authors.initials: H
authors.lastname: Trujillo
authors.forename: A
authors.initials: A
authors.lastname: Levy
authors.forename: M E
authors.initials: ME
authors.lastname: Gama
authors.forename: M
authors.initials: M
authors.lastname: Calle
authors.forename: M L
authors.initials: ML
authors.lastname: Valencia
authors.forename: W
authors.initials: W
authors.lastname: Parra
authors.forename: N
authors.initials: N
authors.lastname: Agudelo
authors.forename: G I
authors.initials: GI
authors.lastname: Mejía
authors.forename: S
authors.initials: S
authors.lastname: Jaramillo
authors.forename: F
authors.initials: F
authors.lastname: Montoya
authors.forename: H
authors.initials: H
authors.lastname: Porras
authors.forename: A
authors.initials: A
authors.lastname: Sánchez
authors.forename: D
authors.initials: D
authors.lastname: Saa
authors.forename: J L
authors.initials: JL
authors.lastname: Di Fabio
authors.forename: A
authors.initials: A
authors.lastname: Homma
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents