1887

Abstract

The role of in cystic fibrosis (CF) is poorly understood. The pneumococcal population has changed over time after the introduction of the heptavalent conjugate vaccine (PCV7) and, more recently, the 13-valent conjugate vaccine (PCV13). Although serotypes and clones causing invasive pneumococcal disease or colonizing healthy children have been extensively analysed, little is known so far on the serotypes and clones of pneumococci in CF patients. The aim of this work was to investigate serotypes, antibiotic susceptibilities, genotypes and biofilm production of CF pneumococcal isolates. Overall, 44 strains collected from 32 paediatric CF patients from January 2010 to May 2012 in a large Italian CF Centre were tested for antimicrobial susceptibility testing by Etest, serotyped by the Quellung reaction and genotyped by a combination of different molecular typing methods, including gene restriction profiling, restriction profiling and sequencing, PFGE and multilocus sequence typing. Biofilm production by pneumococcal strains was also assessed. Penicillin non-susceptibility was 16 %. High resistance rates (>56 %) were observed for erythromycin, clindamycin and tetracycline. The most frequent serotype recovered was serotype 3 (31.8 %). The coverage of PCV7 and PCV13 was 6.8 and 47.7 %, respectively. More than 80 % of CF strains belonged to Pneumococcal Molecular Epidemiology Network (PMEN) reference clones, the most common being Netherlands-ST180 (28.2 %), and Greece-30/ST193 (15.4 %). All strains produced biofilm , although with large variability in biofilm formation efficiency. No correlation was found between biofilm levels and serotype, clone or antibiotic resistance. The high isolation rate of antibiotic-resistant serotype 3 pneumococci from CF patients suggests that PCV13 could increase protection from pneumococcal colonization and infection.

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2014-12-01
2022-05-20
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References

  1. Alfonsi V., D’Ancona F., Giambi C., Nacca G., Rota M. C.Regional Coordinators for Infectious Diseases and Vaccinations 2011; Current immunization policies for pneumococcal, meningococcal C, varicella and rotavirus vaccinations in Italy. Health Policy 103:176–183 [View Article][PubMed]
    [Google Scholar]
  2. Allegrucci M., Hu F. Z., Shen K., Hayes J., Ehrlich G. D., Post J. C., Sauer K. 2006; Phenotypic characterization of Streptococcus pneumoniae biofilm development. J Bacteriol 188:2325–2335 [View Article][PubMed]
    [Google Scholar]
  3. Ansaldi F., de Florentiis D., Canepa P., Zancolli M., Martini M., Orsi A., Durando P., Icardi G. 2012; Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy. Vaccine 30:2288–2294 [View Article][PubMed]
    [Google Scholar]
  4. Antunes L. C., Imperi F., Carattoli A., Visca P. 2011; Deciphering the multifactorial nature of Acinetobacter baumannii pathogenicity. PLoS ONE 6:e22674 [View Article][PubMed]
    [Google Scholar]
  5. Beall B., Gherardi G., Facklam R. R., Hollingshead S. K. 2000; Pneumococcal pspA sequence types of prevalent multiresistant pneumococcal strains in the United States and of internationally disseminated clones. J Clin Microbiol 38:3663–3669[PubMed]
    [Google Scholar]
  6. Beall B., McEllistrem M. C., Gertz R. E. Jr, Wedel S., Boxrud D. J., Gonzalez A. L., Medina M. J., Pai R., Thompson T. A.& other authors ( 2006; Pre- and postvaccination clonal compositions of invasive pneumococcal serotypes for isolates collected in the United States in 1999, 2001, and 2002. J Clin Microbiol 44:999–1017 [View Article][PubMed]
    [Google Scholar]
  7. Bittar F., Rolain J.-M. 2010; Detection and accurate identification of new or emerging bacteria in cystic fibrosis patients. Clin Microbiol Infect 16:809–820 [View Article][PubMed]
    [Google Scholar]
  8. Brueggemann A. B., Peto T. E., Crook D. W., Butler J. C., Kristinsson K. G., Spratt B. G. 2004; Temporal and geographic stability of the serogroup-specific invasive disease potential of Streptococcus pneumoniae in children. J Infect Dis 190:1203–1211 [View Article][PubMed]
    [Google Scholar]
  9. Camilli R., Pantosti A., Baldassarri L. 2011; Contribution of serotype and genetic background to biofilm formation by Streptococcus pneumoniae. Eur J Clin Microbiol Infect Dis 30:97–102 [View Article][PubMed]
    [Google Scholar]
  10. Camilli R., Daprai L., Cavrini F., Lombardo D., D’Ambrosio F., Del Grosso M., Vescio M. F., Landini M. P., Pascucci M. G.& other authors ( 2013; Pneumococcal carriage in young children one year after introduction of the 13-valent conjugate vaccine in Italy. PLoS ONE 8:e76309 [View Article][PubMed]
    [Google Scholar]
  11. Cantón R., del Campo R. 2010; Cystic fibrosis: deciphering the complexity. Clin Microbiol Infect 16:793–797 [View Article][PubMed]
    [Google Scholar]
  12. Dagan R., Patterson S., Juergens C., Greenberg D., Givon-Lavi N., Porat N., Gurtman A., Gruber W. C., Scott D. A. 2013; Comparative immunogenicity and efficacy of 13-valent and 7-valent pneumococcal conjugate vaccines in reducing nasopharyngeal colonization: a randomized double-blind trial. Clin Infect Dis 57:952–962 [View Article][PubMed]
    [Google Scholar]
  13. del Campo R., Morosini M.-I., de la Pedrosa E. G.-G., Fenoll A., Muñoz-Almagro C., Máiz L., Baquero F., Cantón R.Spanish Pneumococcal Infection Study Network 2005; Population structure, antimicrobial resistance, and mutation frequencies of Streptococcus pneumoniae isolates from cystic fibrosis patients. J Clin Microbiol 43:2207–2214 [View Article][PubMed]
    [Google Scholar]
  14. Dicuonzo G., Gherardi G., Gertz R. E., D’Ambrosio F., Goglio A., Lorino G., Recchia S., Pantosti A., Beall B. 2002; Genotypes of invasive pneumococcal isolates recently recovered from Italian patients. J Clin Microbiol 40:3660–3665 [View Article][PubMed]
    [Google Scholar]
  15. Donlan R. M., Costerton J. W. 2002; Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev 15:167–193 [View Article][PubMed]
    [Google Scholar]
  16. Esposito S., Marchese A., Tozzi A. E., Rossi G. A., Da Dalt L., Bona G., Pelucchi C., Schito G. C., Principi N.Italian Pneumococcal CAP Group 2012; Bacteremic pneumococcal community-acquired pneumonia in children less than 5 years of age in Italy. Pediatr Infect Dis J 31:705–710 [View Article][PubMed]
    [Google Scholar]
  17. Ferroni A., Sermet-Gaudelus I., Abachin E., Quesne G., Lenoir G., Berche P., Gaillard J. L. 2002; Use of 16S rRNA gene sequencing for identification of nonfermenting Gram-negative bacilli recovered from patients attending a single cystic fibrosis center. J Clin Microbiol 40:3793–3797 [View Article][PubMed]
    [Google Scholar]
  18. Gherardi G., Whitney C. G., Facklam R. R., Beall B. 2000; Major related sets of antibiotic-resistant pneumococci in the United States as determined by pulsed-field gel electrophoresis and pbp1a-pbp2b-pbp2x-dhf restriction profiles. J Infect Dis 181:216–229 [View Article][PubMed]
    [Google Scholar]
  19. Gherardi G., D’Ambrosio F., Monaco M., Camilli R., De Florio L., D’Ancona F., Dicuonzo G., Pantosti A. 2009; Population structure of invasive Streptococcus pneumoniae isolates in Italy prior to the implementation of the 7-valent conjugate vaccine (1999–2003). Eur J Clin Microbiol Infect Dis 28:99–103 [View Article][PubMed]
    [Google Scholar]
  20. Gherardi G., D’Ambrosio F., Visaggio D., Dicuonzo G., Del Grosso M., Pantosti A. 2012; Serotype and clonal evolution of penicillin-nonsusceptible invasive Streptococcus pneumoniae in the 7-valent pneumococcal conjugate vaccine era in Italy. Antimicrob Agents Chemother 56:4965–4968 [View Article][PubMed]
    [Google Scholar]
  21. Gilligan P. H. 1991; Microbiology of airway disease in patients with cystic fibrosis. Clin Microbiol Rev 4:35–51[PubMed]
    [Google Scholar]
  22. Goffin C., Ghuysen J. M. 2002; Biochemistry and comparative genomics of SxxK superfamily acyltransferases offer a clue to the mycobacterial paradox: presence of penicillin-susceptible target proteins versus lack of efficiency of penicillin as therapeutic agent. Microbiol Mol Biol Rev 66:702–738 [View Article][PubMed]
    [Google Scholar]
  23. Grebe T., Hakenbeck R. 1996; Penicillin-binding proteins 2b and 2x of Streptococcus pneumoniae are primary resistance determinants for different classes of β-lactam antibiotics. Antimicrob Agents Chemother 40:829–834[PubMed]
    [Google Scholar]
  24. Hausdorff W. P., Bryant J., Paradiso P. R., Siber G. R. 2000; Which pneumococcal serogroups cause the most invasive disease: implications for conjugate vaccine formulation and use, part I. Clin Infect Dis 30:100–121 [View Article][PubMed]
    [Google Scholar]
  25. Henriques B., Kalin M., Ortqvist A., Olsson Liljequist B., Almela M., Marrie T. J., Mufson M. A., Torres A., Woodhead M. A.& other authors ( 2000; Molecular epidemiology of Streptococcus pneumoniae causing invasive disease in 5 countries. J Infect Dis 182:833–839 [View Article][PubMed]
    [Google Scholar]
  26. ICONA Working Group 2009; ICONA 2008: national vaccination coverage survey among children and adolescents. Rapporti ISTISAN 09/29. Rome: Istituto Superiore di Sanitá (in Italian). http://www.iss.it/binary/publ/cont/09_29_web.pdf.
    [Google Scholar]
  27. Kaplan S. L., Barson W. J., Lin P. L., Romero J. R., Bradley J. S., Tan T. Q., Hoffman J. A., Givner L. B., Mason E. O. Jr 2013; Early trends for invasive pneumococcal infections in children after the introduction of the 13-valent pneumococcal conjugate vaccine. Pediatr Infect Dis J 32:203–207 [View Article][PubMed]
    [Google Scholar]
  28. Kyaw M. H., Lynfield R., Schaffner W., Craig A. S., Hadler J., Reingold A., Thomas A. R., Harrison L. H., Bennett N. M.& other authors ( 2006; Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med 354:1455–1463 [View Article][PubMed]
    [Google Scholar]
  29. LiPuma J. J. 2010; The changing microbial epidemiology in cystic fibrosis. Clin Microbiol Rev 23:299–323 [View Article][PubMed]
    [Google Scholar]
  30. Maeda Y., Elborn J. S., Parkins M. D., Reihill J., Goldsmith C. E., Coulter W. A., Mason C., Millar B. C., Dooley J. S.& other authors ( 2011; Population structure and characterization of viridans group streptococci (VGS) including Streptococcus pneumoniae isolated from adult patients with cystic fibrosis (CF). J Cyst Fibros 10:133–139 [View Article][PubMed]
    [Google Scholar]
  31. Muñoz R., Dowson C. G., Daniels M., Coffey T. J., Martin C., Hakenbeck R., Spratt B. G. 1992; Genetics of resistance to third-generation cephalosporins in clinical isolates of Streptococcus pneumoniae. Mol Microbiol 6:2461–2465 [View Article][PubMed]
    [Google Scholar]
  32. Oggioni M. R., Trappetti C., Kadioglu A., Cassone M., Iannelli F., Ricci S., Andrew P. W., Pozzi G. 2006; Switch from planktonic to sessile life: a major event in pneumococcal pathogenesis. Mol Microbiol 61:1196–1210 [View Article][PubMed]
    [Google Scholar]
  33. Ogunniyi A. D., Grabowicz M., Briles D. E., Cook J., Paton J. C. 2007; Development of a vaccine against invasive pneumococcal disease based on combinations of virulence proteins of Streptococcus pneumoniae. Infect Immun 75:350–357 [View Article][PubMed]
    [Google Scholar]
  34. Peters B. M., Jabra-Rizk M. A., O’May G. A., Costerton J. W., Shirtliff M. E. 2012; Polymicrobial interactions: impact on pathogenesis and human disease. Clin Microbiol Rev 25:193–213 [View Article][PubMed]
    [Google Scholar]
  35. Renders N., Verbrugh H., Van Belkum A. 2001; Dynamics of bacterial colonisation in the respiratory tract of patients with cystic fibrosis. Infect Genet Evol 1:29–39 [View Article][PubMed]
    [Google Scholar]
  36. Richter S. S., Heilmann K. P., Dohrn C. L., Riahi F., Diekema D. J., Doern G. V. 2013; Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999–2011. Emerg Infect Dis 19:1074–1083 [View Article][PubMed]
    [Google Scholar]
  37. Rolo D., Ardanuy C., Fleites A., Martín R., Liñares J. 2009; Diversity of pneumococcal surface protein A (PspA) among prevalent clones in Spain. BMC Microbiol 9:80 [View Article][PubMed]
    [Google Scholar]
  38. Rosen J. B., Thomas A. R., Lexau C. A., Reingold A., Hadler J. L., Harrison L. H., Bennett N. M., Schaffner W., Farley M. M.& other authors ( 2011; Geographic variation in invasive pneumococcal disease following pneumococcal conjugate vaccine introduction in the United States. Clin Infect Dis 53:137–143 [View Article][PubMed]
    [Google Scholar]
  39. Sharma D., Baughman W., Holst A., Thomas S., Jackson D., da Gloria Carvalho M., Beall B., Satola S., Jerris R.& other authors ( 2013; Pneumococcal carriage and invasive disease in children before introduction of the 13-valent conjugate vaccine: comparison with the era before 7-valent conjugate vaccine. Pediatr Infect Dis J 32:e45–e53 [View Article][PubMed]
    [Google Scholar]
  40. Spellerberg B., Brandt C. 2011; Streptococcus. In Manual of Clinical Microbiology, 10th edn. pp. 331–349 Edited by Versalovic J., Carroll K. C., Funke G., Jorgensen J. H., Landry M. L., Warnock D. W. Washington, DC: American Society for Microbiology;
    [Google Scholar]
  41. Vandevelde N. M., Tulkens P. M., Diaz Iglesias Y., Verhaegen J., Rodriguez-Villalobos H., Philippart I., Cadrobbi J., Coppens N., Boel A.& other authors ( 2014; Characterisation of a collection of Streptococcus pneumoniae isolates from patients suffering from acute exacerbations of chronic bronchitis: in vitro susceptibility to antibiotics and biofilm formation in relation to antibiotic efflux and serotypes/serogroups. Int J Antimicrob Agents 44:209–217 [View Article][PubMed]
    [Google Scholar]
  42. Varaldo P. E., Montanari M. P., Giovanetti E. 2009; Genetic elements responsible for erythromycin resistance in streptococci. Antimicrob Agents Chemother 53:343–353 [View Article][PubMed]
    [Google Scholar]
  43. Zuccotti G., Mameli C., Daprai L., Garlaschi M. L., Dilillo D., Bedogni G., Faccini M., Gramegna M., Torresani E.& other authors ( 2014; Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era. Vaccine 32:527–534 [View Article][PubMed]
    [Google Scholar]
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