Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2015 |
| Outros Autores: | , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/13824 |
Resumo: | Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, Brasil |
| id |
CRUZ_d43d420ad17d9668604370f50c7fbc16 |
|---|---|
| oai_identifier_str |
oai:www.arca.fiocruz.br:icict/13824 |
| network_acronym_str |
CRUZ |
| network_name_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| repository_id_str |
2135 |
| spelling |
Santos, Milena Soares dosAzevedo, JailtonMenezes, Ana Paula de OliveiraCordeiro, Soraia MachadoEscobar, Eliane CunegundesLima, Josilene Borges TCampos, Leila CarvalhoCarvalho, Maria da Gloria SReis, Mitermayer Galvão dosKo, Albert IcksangReis, Joice Neves2016-04-15T13:08:57Z2016-04-15T13:08:57Z2015SANTOS, M. S. dos et al. Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil. BMC Infectious Diseases, v. 15, p. 302, 2015.1471-2334https://www.arca.fiocruz.br/handle/icict/1382410.1186/s12879-015-1049-yengElsevierTemporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Estadual do Sudoeste da Bahia. Jequié, BA, BrasilUniversidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilCenters for Disease Control and Prevention. Streptococcus Laboratory. Atlanta, GA, USAFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, USAFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Farmácia. Departamento de Análises Clínicas e Toxicológicas. Salvador, BA, BrasilBACKGROUND: Hospital-based surveillance for pneumococcal meningitis has been conducted since January 1996 in the city of Salvador, Brazil. The purpose of this study was to describe the temporal evolution of Penicillin Non-Susceptible Streptococcus pneumoniae (PNSSP) in regards to serotype distributions and clonal diversity recovered from meningitis cases over 17 years. METHODS: Broth microdilution was used to identify pneumococcal isolates that were PNSSP (Minimum Inhibitory Concentration > 0.12 µg/ml). The annual incidence rate of meningitis cases was calculated. Serotyping was defined using multiplex polymerase chain reaction assays and quellung reaction. Genetic diversity of PNSSP isolates was assessed using both pulsed-field gel electrophoresis (PFGE) and Multilocus Sequence Typing (MLST) analyses. RESULTS: A total of 854 cerebrospinal fluid (CSF) culture pneumococcal isolates were tested by broth microdilution method and serotyped. A total of 173 (20.3%) were penicillin non-susceptible (PNSSP) (Minimum Inhibitory concentration ≥ 0.12 µg/ml). The annual incidence of meningitis cases declined from 1.65/100,000 population (1996) to 0.2/100,000 population in 2012 and the rate due to PNSSP declined 82% over the 17-years of surveillance. PNSSP isolates were restricted to 13 serotypes, being the most common ones serotypes 14 (45.1%; 78/173), 23 F (19.1%; 33/173), 6B (14.4%; 25/173), 19 F (9.2%; 16/173) and 19A (5.2%; 9/173). Among the PNSSP isolates, 94% had serotypes represented in the 10-valent conjugate vaccine (PCV10). The predominant serotype 14 clonal groups were identified as PFGE group A/multilocus sequence type 66 (ST66) [35.3% (61/173)] and PFGE group GK/ST156 [4.6% (8/173)], the latter one associated with high level resistance to penicillin and ceftriaxone. CONCLUSIONS: Our results show sustained reductions in pneumococcal meningitis cases in the Metropolitan region of Salvador from 1996 to 2012. This might reflect a beneficial impact of conjugate vaccines. Continued surveillance and further studies need to be conducted to better understanding on PCV10 vaccine impact.Streptococcus pneumoniaeAntibiotic resistanceGenotypeSurveillanceMeningite Pneumocócica/epidemiologiaMeningite Pneumocócica/microbiologiaResistência às PenicilinasStreptococcus pneumoniae/classificaçãoVariação AntigênicaTécnicas de Tipagem Bacteriana/métodosBrasil/epidemiologiaCeftriaxona/uso terapêuticoCriançaPré-escolarFemininoVariação GenéticaHumanosIncidênciaLactenteMasculinoMeningite Pneumocócica/quimioterapiaReação em Cadeia da Polimerase MultiplexPenicilina G/uso terapêuticoResistência às Penicilinas/genéticaVacinas Pneumocócicas/uso terapêuticoSorotipageminfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/13824/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALSantos MS Temporal trends....pdfSantos MS Temporal trends....pdfapplication/pdf774496https://www.arca.fiocruz.br/bitstream/icict/13824/2/Santos%20MS%20Temporal%20trends....pdf2fdb06791f67252aa819b6399160844cMD52TEXTSantos MS Temporal trends....pdf.txtSantos MS Temporal trends....pdf.txtExtracted texttext/plain43173https://www.arca.fiocruz.br/bitstream/icict/13824/3/Santos%20MS%20Temporal%20trends....pdf.txt34ffba319a2e2c5a6a50fa7e0d438a1eMD53icict/138242023-03-15 14:33:09.241oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-03-15T17:33:09Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| title |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| spellingShingle |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil Santos, Milena Soares dos Streptococcus pneumoniae Antibiotic resistance Genotype Surveillance Meningite Pneumocócica/epidemiologia Meningite Pneumocócica/microbiologia Resistência às Penicilinas Streptococcus pneumoniae/classificação Variação Antigênica Técnicas de Tipagem Bacteriana/métodos Brasil/epidemiologia Ceftriaxona/uso terapêutico Criança Pré-escolar Feminino Variação Genética Humanos Incidência Lactente Masculino Meningite Pneumocócica/quimioterapia Reação em Cadeia da Polimerase Multiplex Penicilina G/uso terapêutico Resistência às Penicilinas/genética Vacinas Pneumocócicas/uso terapêutico Sorotipagem |
| title_short |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| title_full |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| title_fullStr |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| title_full_unstemmed |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| title_sort |
Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil |
| author |
Santos, Milena Soares dos |
| author_facet |
Santos, Milena Soares dos Azevedo, Jailton Menezes, Ana Paula de Oliveira Cordeiro, Soraia Machado Escobar, Eliane Cunegundes Lima, Josilene Borges T Campos, Leila Carvalho Carvalho, Maria da Gloria S Reis, Mitermayer Galvão dos Ko, Albert Icksang Reis, Joice Neves |
| author_role |
author |
| author2 |
Azevedo, Jailton Menezes, Ana Paula de Oliveira Cordeiro, Soraia Machado Escobar, Eliane Cunegundes Lima, Josilene Borges T Campos, Leila Carvalho Carvalho, Maria da Gloria S Reis, Mitermayer Galvão dos Ko, Albert Icksang Reis, Joice Neves |
| author2_role |
author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Santos, Milena Soares dos Azevedo, Jailton Menezes, Ana Paula de Oliveira Cordeiro, Soraia Machado Escobar, Eliane Cunegundes Lima, Josilene Borges T Campos, Leila Carvalho Carvalho, Maria da Gloria S Reis, Mitermayer Galvão dos Ko, Albert Icksang Reis, Joice Neves |
| dc.subject.en.pt_BR.fl_str_mv |
Streptococcus pneumoniae Antibiotic resistance Genotype Surveillance |
| topic |
Streptococcus pneumoniae Antibiotic resistance Genotype Surveillance Meningite Pneumocócica/epidemiologia Meningite Pneumocócica/microbiologia Resistência às Penicilinas Streptococcus pneumoniae/classificação Variação Antigênica Técnicas de Tipagem Bacteriana/métodos Brasil/epidemiologia Ceftriaxona/uso terapêutico Criança Pré-escolar Feminino Variação Genética Humanos Incidência Lactente Masculino Meningite Pneumocócica/quimioterapia Reação em Cadeia da Polimerase Multiplex Penicilina G/uso terapêutico Resistência às Penicilinas/genética Vacinas Pneumocócicas/uso terapêutico Sorotipagem |
| dc.subject.decs.pt_BR.fl_str_mv |
Meningite Pneumocócica/epidemiologia Meningite Pneumocócica/microbiologia Resistência às Penicilinas Streptococcus pneumoniae/classificação Variação Antigênica Técnicas de Tipagem Bacteriana/métodos Brasil/epidemiologia Ceftriaxona/uso terapêutico Criança Pré-escolar Feminino Variação Genética Humanos Incidência Lactente Masculino Meningite Pneumocócica/quimioterapia Reação em Cadeia da Polimerase Multiplex Penicilina G/uso terapêutico Resistência às Penicilinas/genética Vacinas Pneumocócicas/uso terapêutico Sorotipagem |
| description |
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA / Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, Brasil |
| publishDate |
2015 |
| dc.date.issued.fl_str_mv |
2015 |
| dc.date.accessioned.fl_str_mv |
2016-04-15T13:08:57Z |
| dc.date.available.fl_str_mv |
2016-04-15T13:08:57Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.citation.fl_str_mv |
SANTOS, M. S. dos et al. Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil. BMC Infectious Diseases, v. 15, p. 302, 2015. |
| dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/13824 |
| dc.identifier.issn.none.fl_str_mv |
1471-2334 |
| dc.identifier.doi.none.fl_str_mv |
10.1186/s12879-015-1049-y |
| identifier_str_mv |
SANTOS, M. S. dos et al. Temporal trends and clonal diversity of penicillin non-susceptible pneumococci from meningitis cases from 1996 to 2012, in Salvador, Brazil. BMC Infectious Diseases, v. 15, p. 302, 2015. 1471-2334 10.1186/s12879-015-1049-y |
| url |
https://www.arca.fiocruz.br/handle/icict/13824 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
Elsevier |
| publisher.none.fl_str_mv |
Elsevier |
| dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
| instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
| instacron_str |
FIOCRUZ |
| institution |
FIOCRUZ |
| reponame_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| collection |
Repositório Institucional da FIOCRUZ (ARCA) |
| bitstream.url.fl_str_mv |
https://www.arca.fiocruz.br/bitstream/icict/13824/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/13824/2/Santos%20MS%20Temporal%20trends....pdf https://www.arca.fiocruz.br/bitstream/icict/13824/3/Santos%20MS%20Temporal%20trends....pdf.txt |
| bitstream.checksum.fl_str_mv |
5a560609d32a3863062d77ff32785d58 2fdb06791f67252aa819b6399160844c 34ffba319a2e2c5a6a50fa7e0d438a1e |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ) |
| repository.mail.fl_str_mv |
repositorio.arca@fiocruz.br |
| _version_ |
1798324711923384320 |