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Título:	Pneumococcal serotypes in children, clinical presentation and antimicrobial susceptibility in the PCV13 era
Autor/a:	Izquierdo, Conchita; Ciruela, Pilar; Hernández, Sergi; García-García, Juan José; Esteva, Cristina; Moraga-Llop, Fernando; Díaz-Conradi, A.; Martínez-Osorio, Johanna; Solé-Ribalta, Anna; De Sevilla, Mariona F.; González-Peris, Sebastià; Codina, Gemma; Planes, Ana María; Uriona, Sonia; Campins, Magda; Muñoz-Almagro, Carmen; Salleras, Luis; Domínguez, Ángela
Notas:	The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012–June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2–4 years and 26.9% 5–17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33–22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56–8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2–4 years and 5–17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.
Materia(s):	-Infants -- Salut i higiene -Pneumococs -Vacunes -Penicil·lina -Niños -- Salud e Higiene -Streptococcus pneumoniae -Vacunas -Penicilina -Children -- Health and hygiene -Pneumococcus -Vaccines -Penicillin -61
Derechos:	© The Author(s), 2020. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Tipo de documento:	Artículo Artículo - Versión publicada
Editor:	Cambridge University Press
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