Invasive Pneumococcal Disease in Adults in Portugal: The Importance of Serotypes 8 and 3 (2015–2018)
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Isolate Collection
3.2. Serotype Distribution
3.3. Antimicrobial Susceptibility
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Serotype | No of Isolates (%) | CA 1 | ||
---|---|---|---|---|
18–49 Years | 50–64 Years | ≥65 Years | ||
8 | 120 (30.2) | 116 (23.3) | 177 (13.8) | <0.001 |
3 | 40 (10.1) | 82 (16.5) | 212 (16.6) | 0.005 |
22F | 18 (4.5) | 17 (3.4) | 113 (8.8) | <0.001 |
14 | 15 (3.8) | 28 (5.6) | 95 (7.4) | 0.007 |
19A | 17 (4.3) | 20 (4.0) | 79 (6.2) | 0.068 |
9N | 25 (6.3) | 19 (3.8) | 52 (4.1) | 0.109 |
11A | 10 (2.5) | 23 (4.6) | 44 (3.4) | 0.682 |
20 | 17 (4.3) | 13 (2.6) | 41 (3.2) | 0.455 |
15A | 5 (1.3) | 12 (2.4) | 39 (3.0) | 0.050 |
19F | 7 (1.8) | 13 (2.6) | 36 (2.8) | 0.276 |
6C | 3 (0.8) | 7 (1.4) | 42 (3.3) | 0.001 |
7F | 13 (3.3) | 6 (1.2) | 20 (1.6) | 0.067 |
15B/C | 8 (2.0) | 8 (1.6) | 23 (1.8) | 0.863 |
23A | 7 (1.8) | 9 (1.8) | 23 (1.8) | 0.972 |
10A | 7 (1.8) | 10 (2.0) | 21 (1.6) | 0.765 |
16F | 7 (1.8) | 8 (1.6) | 20 (1.6) | 0.792 |
29/35B | 3 (0.8) | 5 (1.0) | 25 (2.0) | 0.053 |
31 | 1 (0.3) | 5 (1.0) | 26 (2.0) | 0.006 |
12F | 4 (1.0) | 11 (2.2) | 17 (1.3) | 0.998 |
35F | 9 (2.3) | 6 (1.2) | 15 (1.2) | 0.145 |
4 | 10 (2.5) | 10 (2.0) | 8 (0.6) | 0.001 |
23F | 6 (1.5) | 7 (1.4) | 15 (1.2) | 0.564 |
24F | 3 (0.8) | 4 (0.8) | 17 (1.3) | 0.262 |
33F | 2 (0.5) | 6 (1.2) | 15 (1.2) | 0.324 |
Serotype 1 | No. of Isolates (%) | CA 2 | CA 2 | ||||||
---|---|---|---|---|---|---|---|---|---|
Current Study Period | |||||||||
2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2015–2018 | 2012–2018 | |
PCV13 | |||||||||
1 | 12 (3.0) | 7 (1.8) | 7 (1.9) | 2 (0.4) | 2 (0.4) | 0 (0.0) | 0 (0.0) | 0.063 | <0.001 |
3 | 66 (16.3) | 45 (11.7) | 50 (13.3) | 72 (13.6) | 79 (15.8) | 84 (14.6) | 99 (17.5) | 0.125 | 0.154 |
4 | 6 (1.5) | 8 (2.1) | 9 (2.4) | 7 (1.3) | 8 (1.6) | 8 (1.4) | 5 (0.9) | 0.478 | 0.171 |
6A | 2 (0.5) | 1 (0.3) | 4 (1.1) | 4 (0.8) | 3 (0.6) | 1 (0.2) | 4 (0.7) | 0.698 | 0.937 |
6B | 5 (1.2) | 5 (1.3) | 5 (1.3) | 3 (0.6) | 1 (0.2) | 6 (1.0) | 1 (0.2) | 0.795 | 0.031 |
7F | 33 (8.2) | 18 (4.7) | 10 (2.7) | 16 (3.0) | 9 (1.8) | 7 (1.2) | 7 (1.2) | 0.020 | <0.001 |
9V | 4 (1.0) | 4 (1.0) | 1 (0.3) | 7 (1.3) | 1 (0.2) | 3 (0.5) | 4 (0.7) | 0.340 | 0.344 |
14 | 29 (7.2) | 26 (6.8) | 18 (4.8) | 39 (7.4) | 41 (8.2) | 31 (5.4) | 27 (4.8) | 0.024 | 0.196 |
18C | 1 (0.2) | 4 (1.0) | 2 (0.5) | 3 (0.6) | 3 (0.6) | 5 (0.9) | 2 (0.4) | 0.795 | 0.998 |
19A | 39 (9.7) | 24 (6.3) | 21 (5.6) | 36 (6.8) | 27 (5.4) | 37 (6.4) | 16 (2.8) | 0.011 | <0.001 |
19F | 9 (2.2) | 12 (3.1) | 6 (1.6) | 17 (3.2) | 12 (2.4) | 12 (2.1) | 15 (2.7) | 0.518 | 0.964 |
23F | 1 (0.2) | 3 (0.8) | 9 (2.4) | 6 (1.1) | 8 (1.6) | 4 (0.7) | 10 (1.8) | 0.632 | 0.213 |
addPPV23 | |||||||||
8 | 34 (8.4) | 43 (11.2) | 46 (12.2) | 79 (14.9) | 92 (18.4) | 117 (20.3) | 125 (22.1) | 0.002 | <0.001 |
9N | 8 (2.0) | 13 (3.4) | 18 (4.8) | 24 (4.5) | 19 (3.8) | 23 (4.0) | 30 (5.3) | 0.455 | 0.039 |
10A | 2 (0.5) | 8 (2.1) | 8 (2.1) | 9 (1.7) | 11 (2.2) | 8 (1.4) | 10 (1.8) | 0.815 | 0.486 |
11A | 16 (4.0) | 18 (4.7) | 15 (4.0) | 19 (3.6) | 17 (3.4) | 14 (2.4) | 27 (4.8) | 0.453 | 0.626 |
12F | 6 (1.5) | 8 (2.1) | 4 (1.1) | 5 (0.9) | 3 (0.6) | 9 (1.6) | 15 (2.7) | 0.008 | 0.349 |
15B/C | 5 (1.2) | 9 (2.3) | 8 (2.1) | 7 (1.3) | 8 (1.6) | 16 (2.8) | 8 (1.4) | 0.578 | 0.756 |
17F | 5 (1.2) | 2 (0.5) | 2 (0.5) | 5 (0.9) | 2 (0.4) | 3 (0.5) | 8 (1.4) | 0.371 | 0.775 |
20 | 14 (3.5) | 11 (2.9) | 14 (3.7) | 18 (3.4) | 17 (3.4) | 23 (4.0) | 13 (2.3) | 0.420 | 0.665 |
22F | 25 (6.2) | 23 (6.0) | 31 (8.2) | 40 (7.5) | 34 (6.8) | 45 (7.8) | 29 (5.1) | 0.191 | 0.759 |
33F | 1 (0.2) | 1 (0.3) | 1 (0.3) | 1 (0.2) | 6 (1.2) | 7 (1.2) | 9 (1.6) | 0.031 | 0.001 |
NVT | |||||||||
6C | 8 (2.0) | 14 (3.7) | 6 (1.6) | 20 (3.8) | 14 (2.8) | 8 (1.4) | 10 (1.8) | 0.011 | 0.212 |
7C | 1 (0.2) | 4 (1.0) | 1 (0.3) | 2 (0.4) | 2 (0.4) | 5 (0.9) | 5 (0.9) | 0.196 | 0.308 |
15A | 3 (0.7) | 11 (2.9) | 13 (3.5) | 12 (2.3) | 14 (2.8) | 14 (2.4) | 16 (2.8) | 0.660 | 0.235 |
16F | 13 (3.2) | 3 (0.8) | 7 (1.9) | 11 (2.1) | 8 (1.6) | 13 (2.3) | 3 (0.5) | 0.095 | 0.079 |
23A | 9 (2.2) | 8 (2.1) | 9 (2.4) | 13 (2.5) | 7 (1.4) | 12 (2.1) | 7 (1.2) | 0.161 | 0.159 |
23B | 4 (1.0) | 5 (1.3) | 3 (0.8) | 6 (1.1) | 3 (0.6) | 4 (0.7) | 6 (1.1) | 0.951 | 0.632 |
24F | 5 (1.2) | 9 (2.3) | 9 (2.4) | 7 (1.3) | 7 (1.4) | 5 (0.9) | 5 (0.9) | 0.359 | 0.075 |
25A/38 | 3 (0.7) | 3 (0.8) | 2 (0.5) | 1 (0.2) | 3 (0.6) | 5 (0.9) | 1 (0.2) | 0.870 | 0.448 |
29/35B | 10 (2.5) | 6 (1.6) | 10 (2.7) | 6 (1.1) | 7 (1.4) | 14 (2.4) | 10 (1.8) | 0.241 | 0.709 |
31 | 5 (1.2) | 2 (0.5) | 4 (1.1) | 6 (1.1) | 10 (2.0) | 9 (1.6) | 7 (1.2) | 0.956 | 0.309 |
33A | 2 (0.5) | 5 (1.3) | 2 (0.5) | 4 (0.8) | 0 (0.0) | 0 (0.0) | 1 (0.2) | 0.060 | 0.010 |
34 | 3 (0.7) | 1 (0.3) | 4 (1.1) | 5 (0.9) | 3 (0.6) | 1 (0.2) | 3 (0.5) | 0.245 | 0.431 |
35F | 7 (1.7) | 4 (1.0) | 2 (0.5) | 5 (0.9) | 11 (2.2) | 6 (1.0) | 8 (1.4) | 0.904 | 0.808 |
NT | 1 (0.2) | 3 (0.8) | 6 (1.6) | 2 (0.4) | 1 (0.2) | 3 (0.5) | 2 (0.4) | 0.834 | 0.380 |
Other | 7 (1.7) | 12 (3.1) | 9 (2.4) | 11 (2.1) | 8 (1.6) | 14 (2.4) | 18 (3.2) | ||
Total | 404 | 383 | 376 | 530 | 501 | 576 | 566 | - | - |
Age Group (Years) | Serotype Group 1 | No. of Isolates (%) | CA 2 | |||
---|---|---|---|---|---|---|
2015 | 2016 | 2017 | 2018 | |||
18–49 | PCV7 | 8 (7.8) | 14 (16.5) | 12 (10.9) | 8 (8.1) | 0.807 |
addPCV13 | 23 (22.3) | 19 (22.4) | 15 (13.6) | 22 (22.2) | 0.593 | |
addPCV15 | 13 (12.6) | 3 (3.5) | 4 (3.6) | 0 (0) | <0.001 | |
addPCV20 | 35 (34.0) | 28 (32.9) | 44 (40.0) | 42 (42.4) | 0.139 | |
addPPV23 | 11 (10.7) | 8 (9.4) | 13 (11.8) | 15 (15.2) | 0.286 | |
NVT | 13 (12.6) | 13 (15.3) | 22 (20.0) | 12 (12.1) | 0.802 | |
50–64 | PCV7 | 21 (16.9) | 16 (14.0) | 18 (14.4) | 15 (11.2) | 0.216 |
addPCV13 | 33 (26.6) | 26 (22.8) | 24 (19.2) | 27 (20.1) | 0.166 | |
addPCV15 | 2 (1.6) | 7 (6.1) | 7 (5.6) | 7 (5.2) | 0.218 | |
addPCV20 | 30 (24.2) | 44 (38.6) | 44 (35.2) | 51 (38.1) | 0.041 | |
addPPV23 | 13 (10.5) | 3 (2.6) | 6 (4.8) | 13 (9.7) | 0.993 | |
NVT | 25 (20.2) | 18 (15.8) | 26 (20.8) | 21 (15.7) | 0.558 | |
≥65 | PCV7 | 53 (17.5) | 44 (14.6) | 39 (11.4) | 41 (12.3) | 0.033 |
addPCV13 | 74 (24.4) | 75 (24.8) | 90 (26.4) | 77 (23.1) | 0.819 | |
addPCV15 | 26 (8.6) | 30 (9.9) | 41 (12.0) | 31 (9.3) | 0.584 | |
addPCV20 | 54 (17.8) | 59 (19.5) | 78 (22.9) | 92 (27.6) | 0.002 | |
addPPV23 | 23 (7.6) | 27 (8.9) | 30 (8.8) | 23 (6.9) | 0.733 | |
NVT | 73 (24.1) | 67 (22.2) | 63 (18.5) | 69 (20.7) | 0.183 |
No. Resistant Isolates (%) | |||
---|---|---|---|
Antimicrobial 1 | 18–49 Years (n = 397) | 50–64 Years (n = 497) | ≥65 Years (n = 1278) 2 |
PEN | 44 (11.1) | 65 (13.8) | 217 (17.0) |
MIC90 3 | 0.016 | 0.125 | 0.5 |
MIC50 3 | 0.012 | 0.012 | 0.012 |
CTX | 1 (0.3) | 2 (0.4) | 3 (0.2) |
MIC90 3 | 0.016 | 0.125 | 0.38 |
MIC50 3 | 0.016 | 0.016 | 0.016 |
LEV | 2 (0.5) | 2 (0.4) | 9 (0.7) |
ERY | 51 (12.8) | 57 (11.5) | 214 (16.7) |
CLI | 41 (10.3) | 49 (9.9) | 185 (14.5) |
CHL | 5 (1.3) | 12 (2.4) | 23 (1.8) |
SXT | 47 (11.8) | 62 (12.5) | 175 (13.7) |
TET | 53 (13.4) | 79 (15.9) | 214 (16.7) |
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Silva-Costa, C.; Gomes-Silva, J.; Teodoro, I.; Ramirez, M.; Melo-Cristino, J.; on behalf of the Portuguese Group for the Study of Streptococcal Infections. Invasive Pneumococcal Disease in Adults in Portugal: The Importance of Serotypes 8 and 3 (2015–2018). Microorganisms 2021, 9, 1016. https://doi.org/10.3390/microorganisms9051016
Silva-Costa C, Gomes-Silva J, Teodoro I, Ramirez M, Melo-Cristino J, on behalf of the Portuguese Group for the Study of Streptococcal Infections. Invasive Pneumococcal Disease in Adults in Portugal: The Importance of Serotypes 8 and 3 (2015–2018). Microorganisms. 2021; 9(5):1016. https://doi.org/10.3390/microorganisms9051016
Chicago/Turabian StyleSilva-Costa, Catarina, Joana Gomes-Silva, Inês Teodoro, Mário Ramirez, José Melo-Cristino, and on behalf of the Portuguese Group for the Study of Streptococcal Infections. 2021. "Invasive Pneumococcal Disease in Adults in Portugal: The Importance of Serotypes 8 and 3 (2015–2018)" Microorganisms 9, no. 5: 1016. https://doi.org/10.3390/microorganisms9051016
APA StyleSilva-Costa, C., Gomes-Silva, J., Teodoro, I., Ramirez, M., Melo-Cristino, J., & on behalf of the Portuguese Group for the Study of Streptococcal Infections. (2021). Invasive Pneumococcal Disease in Adults in Portugal: The Importance of Serotypes 8 and 3 (2015–2018). Microorganisms, 9(5), 1016. https://doi.org/10.3390/microorganisms9051016