title: Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae prior to introduction of the 10-valent pneumococcal conjugate vaccine in Brazil, 2000-2007.
abstract: This study describes the serotype distribution and antibiotic resistance patterns among 397 S. pneumoniae meningitis case isolates recovered in Salvador, Brazil, during the period of 2000-2007, before introduction of the 10-valent pneumococcal conjugate vaccine. The active hospital-based surveillance showed a decline in the annual incidence rates of pneumococcal meningitis during the period of study, from 1.12 cases to 0.83 cases/100,000 persons for all age groups (P<0.001), with an overall case-fatality rate of 28.6% (113 of 395) for all patients and 41.9% (57 of 136) for those <5 years of age. Serotypes 14 (n=55; 13.9%), 3 (n=32; 8.1%), 23F (n=32; 8.1%), 19F (n=31; 7.8%), 6B (n=30; 7.6%), 18C (n=28; 7.1%), and 6A (n=20; 5%) were the most prevalent serotypes. In patients <5 years the estimated projected coverage of 7-, 10- and 13-valent conjugate vaccines was 74.3%, 75.7% and 83.1%, respectively. Antimicrobial susceptibility testing revealed that 22.1% (n=88) of isolates were non-susceptible to penicillin, 56% were non-susceptible to trimethoprim/sulphamethoxazole, and 29.6% were non-susceptible to tetracycline. Nonsusceptibility to penicillin and cefotaxime was detected solely among serotype 14 isolates (n=4; 1%). This study provides an important baseline to assess the impact of conjugate vaccine implantation on the epidemiology of meningitis due to Streptococcus pneumoniae in Salvador, Brazil.
authors.affiliation: Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA 40296-710, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: de O Menezes
authors.forename: Leila C
authors.initials: LC
authors.lastname: Campos
authors.forename: Milena S
authors.initials: MS
authors.lastname: dos Santos
authors.forename: Jailton
authors.initials: J
authors.lastname: Azevedo
authors.forename: Renan C N
authors.initials: RC
authors.lastname: Dos Santos
authors.forename: Maria da Gloria S
authors.initials: Mda G
authors.lastname: Carvalho
authors.forename: Bernard W
authors.initials: BW
authors.lastname: Beall
authors.forename: Stacey W
authors.initials: SW
authors.lastname: Martin
authors.forename: Katia
authors.initials: K
authors.lastname: Salgado
authors.forename: Mitermayer G
authors.initials: MG
authors.lastname: Reis
authors.forename: Albert I
authors.initials: AI
authors.lastname: Ko
authors.forename: Joice N
authors.initials: JN
authors.lastname: Reis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: C538863:10-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines