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Ranjith Jayaraman Rosemol Varghese Jones Lionel Kumar Ayyanraj Neeravi Devika Shanmugasundaram Ravikar Ralph Kurien Thomas Balaji Veeraraghavan 《Journal of microbiology, immunology, and infection》2019,52(5):736-742
PurposeTo investigate the epidemiology of invasive pneumococcal disease (IPD), prevalent serotypes, and pattern of antimicrobial resistance (AMR) in Indian adults.MethodsProspective laboratory based surveillance of IPD was carried out in >18 years age group between January 2007 and July 2017, from a tertiary care hospital in South India. All Streptococcus pneumoniae culture positives from blood, CSF and sterile body fluids were characterized to identify the serotypes and AMR.ResultsA total of 408 IPD cases were characterized in this study. The overall case fatality rate in this study was 17.8% (95% confidence interval (CI): 14.1, 22.4). Pneumonia (39%), meningitis (24.3%), and septicaemia (18.4%) were the most common clinical conditions associated with IPD. Serotypes 1, 3, 5, 19F, 8, 14, 23F, 4, 19A and 6B were the predominant serotypes in this study. Penicillin non-susceptibility was low with 6.4%ConclusionSerotype data from this study helped in accurate estimation of pneumococcal conjugate vaccine-13 and pneumococcal polysaccharide vaccine-23 protective coverage against serotypes causing IPD in India as 58.7% (95% CI: 53.8, 63.4) and 67.4% (95% CI: 62.7, 71.8) respectively. Penicillin non-susceptibility in meningeal IPD cases is 27.4%. Empirical therapy for meningeal IPD must be cephalosporin in combination with vancomycin since cefotaxime non-susceptibility in meningeal IPD is 9.9% 相似文献
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James John Rosemol Varghese Jones Lionell Ayyanraj Neeravi Balaji Veeraraghavan 《Indian pediatrics》2018,55(10):874-876
Objective
To report the percentage of non-vaccine pneumococcal serotypes and their antibiotic susceptibility pattern in children with invasive peumococcal disease.Methods
Invasive pneumococcal isolates of children <5 years during January 2007 to December 2016 were serotyped by a co-agglutination reaction and sequential multiplex polymerase chain reaction.Results
Among the total 170 S. pneumoniae invasive isolates, 54 (31.8%) and 44 (25.9 %) were the serotypes, which are not included in current 10-valent or 13-valent vaccines, respectively. Very low resistance was observed against penicillin (4.5%) and all isolates were susceptible to cefotaxime.Conclusions
One-fourth to one-third of the S. pneumoniae serotypes in under-five children with invasive pneumococcal disease are not covered by existing pneumococcal vaccines in India.
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