Streptococcus pneumoniae: serotype distribution, antimicrobial susceptibility, risk factors and mortality in Galicia over a two year-period

• Published in: Enfermedades infecciosas y microbiologia clinica Vol. 33; no. 9; p. 579
• Main Authors: Méndez-Lage, Susana, Losada-Castillo, Isabel, Agulla-Budiño, Andrés
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.11.2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - pharmacology; Child; Child, Preschool; Comorbidity; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Resistance, Multiple, Bacterial; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Middle Aged; Pneumococcal Infections - drug therapy; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Pneumococcal Vaccines; Retrospective Studies; Risk Factors; Serotyping; Spain - epidemiology; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - isolation & purification; Survival Rate; Vaccines, Conjugate; Young Adult; Vacunación; Susceptibility; Vaccination; Serotypes; Invasive pneumococcal disease; Serotipos; Enfermedad neumocócica invasora; Sensibilidad; Streptococcus pneumonia; Streptococcus pneumoniae
• ISSN: 1578-1852
• DOI: 10.1016/j.eimc.2015.01.010

To examine the epidemiology of pneumococcal infection in Galicia (Spain) after the incorporation of the pneumococcal conjugate vaccine, and to determine serotype distribution, antibiotic susceptibility, risk factors and associated mortality in cases of invasive pneumococcal disease (IPD) during 2011 and 2012. All strains causing IPD in Galicia were studied. Serotyping was performed by agglutination and Quellung reaction. Antibiotic sensitivity to penicillin, cefotaxime, erythromycin, vancomycin, and levofloxacin was determined. The risk factors considered were chronic respiratory disease, heart disease, liver disease, kidney disease, diabetes mellitus, and HIV and non-HIV immunodeficiency. A total of 555 strains were collected, with 43 different serotypes being found. The most frequently isolated ones were: serotype3 (17.5%), serotype7F (12.6%), serotype19A (9.4%), serotype14 (4.1%), serotype6C (4.1%), serotype11A (4%) and serotype22F (3.8%). 57.1% of isolates were serotypes included in VNC-13V. Two non-penicillin-sensitive strains and two others were not sensitive to cefotaxime, and 24.7% of the strains were not susceptible to erythromycin (26.9% in 2011 and 22.5% in 2012). The case fatality rate was 16.5%, reaching 23.3% in patients over 75years. Diseases with a statistically significant risk of mortality were: liver, kidney and immunodeficiency without HIV. Serotype3 was the most frequent in Galicia. Very few strains were not susceptible to penicillin. Erythromycin resistance decreased from 2011 to 2012. It is highlighted that mortality increases with age. Liver disease, renal disease and non-HIV immunodeficiency increases the mortality risk.