title: PspA family distribution, antimicrobial resistance and serotype of Streptococcus pneumoniae isolated from upper respiratory tract infections in Japan.
abstract: BACKGROUND
  The protection against pneumococcal infections provided by currently available pneumococcal polysaccharide conjugate vaccines are restricted to the limited number of the serotypes included in the vaccine. In the present study, we evaluated the distribution of the pneumococcal capsular type and surface protein A (PspA) family of pneumococcal isolates from upper respiratory tract infections in Japan.
  
  
  METHODS
  A total of 251 S. pneumoniae isolates from patients seeking treatment for upper respiratory tract infections were characterized for PspA family, antibiotic resistance and capsular type.
  
  
  RESULTS
  Among the 251 pneumococci studied, the majority (49.4%) was identified as belonging to PspA family 2, while most of the remaining isolates (44.6%) belonged to family 1. There were no significant differences between the distributions of PspA1 versus PspA2 isolates based on the age or gender of the patient, source of the isolates or the isolates' susceptibilities to penicillin G. In contrast, the frequency of the mefA gene presence and of serotypes 15B and 19F were statistically more common among PspA2 strains.
  
  
  CONCLUSIONS
  The vast majority of pneumococci isolated from the middle ear fluids, nasal discharges/sinus aspirates or pharyngeal secretions represented PspA families 1 and 2. Capsular serotypes were generally not exclusively associated with certain PspA families, although some capsular types showed a much higher proportion of either PspA1 or PspA2. A PspA-containing vaccine would potentially provide high coverage against pneumococcal infectious diseases because it would be cross-protective versus invasive disease with the majority of pneumococci infecting children and adults.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama-shi, Wakayama, Japan. mhotomi@wakayama-med.ac.jp
authors.forename: Muneki
authors.initials: M
authors.lastname: Hotomi
authors.forename: Akihisa
authors.initials: A
authors.lastname: Togawa
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Kono
authors.forename: Yorihiko
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Shin
authors.initials: S
authors.lastname: Takei
authors.forename: Susan K
authors.initials: SK
authors.lastname: Hollingshead
authors.forename: David E
authors.initials: DE
authors.lastname: Briles
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D018942:Macrolides / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000494:pharmacology; D022242:Pneumococcal Vaccines / Q000276:immunology; D012141:Respiratory Tract Infections / Q000276:immunology / Q000382:microbiology* / Q000517:prevention & control; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D018942:Macrolides; D022242:Pneumococcal Vaccines; C051592:pneumococcal surface protein A; D010400:Penicillin G