Changes in serotype distribution and antibiotic resistance of nasopharyngeal isolates of Streptococcus pneumoniae from children in Korea, after optional use of the 7-valent conjugate vaccine

Abstract

We investigated serotype distribution and antimicrobial resistance of pneumococcal carriage isolates from children after optional immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) in Korea. From June 2009 to June 2010, 205 (16.5%) pneumococcal isolates were obtained from 1,243 nasopharyngeal aspirates of infants and children at Seoul National University Children's Hospital, Korea. Serotype was determined by Quellung reaction and antibiotic susceptibility was tested by E-test. The results were compared to previous studies done in the pre-PCV7 period. In this study, the most common serotypes were 6A (15.3%), 19A (14.7%), 19F (10.2%), 35B (7.3%), and 6D (5.6%). The proportion of PCV7 serotypes decreased from 61.9% to 23.8% (P < 0.001). The overall penicillin nonsusceptibility rate increased from 83.5% to 95.4% (P = 0.001). This study demonstrates the impact of optional PCV7 vaccination in Korea; the proportion of all PCV7 serotypes except 19F decreased while antimicrobial resistant serotypes 6A and 19A further increased.

Keywords: Drug Resistance; Pneumococcal Vaccines; Serotype; Streptococcus pneumoniae.

Fig. 1

Distribution of serotypes with regard to 7-valent conjugate vaccine (PCV7) among pneumococcal isolates from nasopharyngeal aspirates of children < 5 yr of age during 1997-2002 and 2009-2010 periods in Korea. ^*Differentiation of 6C/6D from 6A/6B was not done in 1997-2002 studies; ^†Statistically significant (P < 0.05, by Fisher exact test) increase or decrease in the proportion of each serotypes are marked.