Abstract
Serotype 3 is one of the most often detected pneumococcal serotypes in adults and it is associated with serious disease. In contrast, the isolation of serotype 3 by bacterial culture is unusual in children with invasive pneumococcal disease (IPD). The purpose of this study was to learn the serotype distribution of IPD, including culture-negative episodes, by using molecular methods in normal sterile samples. We studied all children <5 years of age with IPD admitted to two paediatric hospitals in Catalonia, Spain, from 2007 to 2009. A sequential real-time polymerase chain reaction (PCR) approach was added to routine methods for the detection and serotyping of pneumococcal infection. Among 257 episodes (219 pneumonia, 27 meningitis, six bacteraemia and five others), 33.5% were identified by culture and the rest, 66.5%, were detected exclusively by real-time PCR. The most common serotypes detected by culture were serotypes 1 (26.7%) and 19A (25.6%), and by real-time PCR, serotypes 1 (19.8%) and 3 (18.1%). Theoretical coverage rates by the PCV7, PCV10 and PCV13 vaccines were 10.5, 52.3 and 87.2%, respectively, for those episodes identified by culture, compared to 5.3, 31.6 and 60.2% for those identified only by real-time PCR. Multiplex real-time PCR has been shown to be useful for surveillance studies of IPD. Serotype 3 is underdiagnosed by culture and is important in paediatric IPD.
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Acknowledgements
This work was supported by Fondo de Investigación Sanitaria (FIS, project number 06/1597), Caja Navarra Foundation and AGAUR 2009/SGR00136.
We are very appreciative of Dr. Fenoll (National Center of Microbiology, Majadahonda, Madrid, Spain) for the conventional serotyping of isolates.
This paper was published in part at the 7th International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD-7), Tel Aviv, Israel, March 14–18, 2010 (abstract P-134).
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P. Ciruela., M.F. de Sevilla, S. Hernandez and J.J. García-García have received a travel grant from Pfizer. F. Moraga has received honoraria for consultancy and speaking at scientific meetings from Pfizer and GSK. L. Salleras has received travel grants and honoraria for speaking at scientific meetings organised by Sanofi Pasteur MSD, GSK, Novartis Vaccines, Pfizer, Crucell Berna and Esteve.
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Selva, L., Ciruela, P., Esteva, C. et al. Serotype 3 is a common serotype causing invasive pneumococcal disease in children less than 5 years old, as identified by real-time PCR. Eur J Clin Microbiol Infect Dis 31, 1487–1495 (2012). https://doi.org/10.1007/s10096-011-1468-7
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DOI: https://doi.org/10.1007/s10096-011-1468-7