Changes of serotype and genotype in Streptococcus pneumoniae isolates from a Korean hospital in 2007

Abstract

We investigated the change in clones and serotypes of Streptococcus pneumoniae isolates in a Korean tertiary-care hospital. Serotypes of S. pneumoniae isolates were determined by the capsular quellung method, and in vitro susceptibility testing was performed by broth microdilution method. Multilocus sequence typing was performed to determine the genotypes of the S. pneumoniae isolates. The erm(B) and mef(A) genes in erythromycin-resistant isolates were also detected using the duplex polymerase chain reaction method. During the 2 periods assayed (1998-2000 and 2007), 7-valent pneumococcal conjugate vaccine (PCV7) serotypes decreased significantly from 58.3% to 30.9% (P = 0.001). Especially, serotypes 19F and 23F decreased significantly from 31.7% to 8.5% (P < 0.0001) and from 20.0% to 7.4% (P = 0.021), respectively. In contrast to the other PCV7 serotypes, serotype 14 coupled with CC554 emerged in 2007, which may indicate no effect of PCV7 against serotype 14 isolates from Korea and the possibility of a different subtype. Of the non- PCV7 serotypes, serotype 19A increased from 8.3% to 14.9% (P = 0.227) and serotype 15 increased from 0% to 8.5% (P = 0.023). The increase of serotype 19A was due to the expansion of a preexisting clone with serotype 19A, ST320. However, S. pneumoniae isolates of serotype 15 showed diverse STs. Our data may provide helpful information in local vaccine serotype expansion or replacement in Korea.