Predominance of Serogroup 19 CC320/271 among Penicillin-Nonsusceptible Streptococcus pneumoniae Isolates after Introduction of the PCV7 Vaccine in Several Regions of Japan

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  • Oodate Mitsuru
    Department of Bacteriology, Nagoya University Graduate School of Medicine Department of Respiratory Medicine, Nagoya University Graduate School of Medicine
  • Kimura Kouji
    Department of Bacteriology, Nagoya University Graduate School of Medicine
  • Banno Hirotsugu
    Department of Bacteriology, Nagoya University Graduate School of Medicine
  • Yokoyama Satoru
    Department of Bacteriology, Nagoya University Graduate School of Medicine
  • Jin Wanchun
    Department of Bacteriology, Nagoya University Graduate School of Medicine
  • Wachino Jun-ichi
    Department of Bacteriology, Nagoya University Graduate School of Medicine
  • Hasegawa Yoshinori
    Department of Respiratory Medicine, Nagoya University Graduate School of Medicine
  • Arakawa Yoshichika
    Department of Bacteriology, Nagoya University Graduate School of Medicine

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  • Predominance of Serogroup 19 CC320/271 among Penicillin-Nonsusceptible <i>Streptococcus pneumoniae</i> Isolates after Introduction of the PCV7 Vaccine in Several Regions of Japan

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<p>Multidrug-resistant Streptococcus pneumoniae serogroup 19, including serotypes 19A and 19F, associated with clonal complex 320/271 (CC320/271), has been previously shown to be predominant in many countries after introduction of a 7-valent pneumococcal conjugate vaccine (PCV7). However, in Japan there has been no epidemiological research focused on penicillin-nonsusceptible isolates after this event. Therefore, we aimed to characterize penicillin-nonsusceptible S. pneumoniae (PNSSP; penicillin minimum inhibitory concentration [MIC] ≥ 4.0 μg/ml) after the introduction of PCV7 in Japan. Throughout Japan, we collected 1,057 pneumococcal isolates from 2010 to 2014. We then evaluated MICs and performed serotyping, multilocus sequence typing, and sequencing of penicillin-binding protein genes in 51 isolates (penicillin MIC ≥ 2.0 μg/ml). Twenty-three isolates (2.2%) showed penicillin nonsusceptibility (penicillin MIC ≥ 4.0 μg/ml). Serotypes 19F (14 isolates, 60.9%) and 23F (4 isolates, 17.4%), which are covered by the vaccine, were predominant among PNSSP strains. Only 3 isolates belonged to nonvaccine serotype 19A. Among the PNSSP isolates, CC320/271 (16/23 strains, 69.6%) was the most prevalent clone. Moreover, CC320/271 clones showed high MIC values of a third-generation cephalosporin. Thus, we demonstrated clonal predominance of serogroup 19 CC320/271 with strong resistance to β-lactams including a third-generation cephalosporin among PNSSP isolates.</p>

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