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Le Touquet – Paris-Plage, France

Brieu N.,Limoges University Hospital Center | Varon E.,Center National Of Reference Des Pneumocoques Cnrp | Baraduc R.,Limoges University Hospital Center | Brun M.,Limoges University Hospital Center | And 26 more authors.
Journal des Anti-Infectieux | Year: 2015

Background: Survey of antibiotic resistance and serotype distribution of Streptococcus pneumoniae is based in France on a network of regional pneumococcal observatories, the National reference center and the Institut de veille sanitaire. Methods: Between 2009 and 2013, the 23 French regional pneumococcal observatories collected and analysed 13,033 Streptococcus pneumoniae isolates, including 2953 (22.7%) from children and 10,080 (77.3%) from adults. Results: During this period, the number of strains isolated decreased from 42.1%. The decrease was particularly important in children, both for invasive infections (-59.7%) and for acute otitis media (-74.4%). In adults, the number of strains isolated during invasive infections decreased from -31.0%. In parallel, a decrease of penicillin non-susceptible pneumococci was observed (34.2% in 2009 vs. 25.7% in 2013), as well as a decrease of resistance to amoxicillin (17.9% in 2009 vs. 11.6% in 2013) and to cefotaxime (9.7% in 2009 vs. 6.0% in 2013). In 2009, prevalence of PCV13 vaccine serotypes was of 64.2% and in 2013, of 35.6% (-28.6%). Besides, the non-PCV13 vaccine serotypes 12F, 22F, 24F, 15A, 10A and 23B increased. Conclusion: Surveillance of resistance and serotype distribution remains important because S. pneumoniae represents, due to its frequency and severity, a major public health issue. © 2015 Elsevier Masson SAS.

Janoir C.,Center National Of Reference Des Pneumocoques Cnrp | Cohen R.,Center Hospitalier Intercommunal Of Creteil | Bingen E.,Groupe de Pathologie Infectieuse Pediatrique GPIP | Bingen E.,University Paris Diderot | And 29 more authors.
PLoS ONE | Year: 2014

In France, the use of the 7-valent pneumococcal conjugate vaccine (PCV7) lead to an overall significant decrease in PCV7 invasive pneumococcal disease (IPD) incidence. However, the decrease in vaccine serotype prevalence was partially counterbalanced by the serotype replacement phenomenon. In this study, we analyzed the role of the newly described serotype 6C as one of the replacement serotypes. This work was conducted on a large time scale from the early PCV7 era (2002-2003) to the PCV13 era (2010-2011), both on IPD strains recovered from the whole population and nasopharyngeal colonizing strains isolated in infant less than two years, who are known to be the main reservoir for pneumococci. Serotype 6C took advantage over 6A and 6B serotypes, which both decreased over time. A continuous and significant increase in 6C IPD was observed in adults along the study period; in contrast, in children less than two years, only an increase in 6C nasopharyngeal carriage was found, the prevalence of serotype 6C in IPD remaining very low over time. Among 101 6C invasive and colonizing strains studied by MLST, 24 STs were found to be related to three major clonal complexes, CC395, CC176, and CC315. STs related to CC176 tend to disappear after 2009 and were essentially replaced by ST386 (CC315), which dramatically increased over time. This clonal expansion may be explained by the erythromycin and tetracycline resistances associated with this clone. Finally, the decrease observed in nasopharyngeal 6C carriage since 2010, likely related to the PCV13 introduction in the French immunization schedule, is expected to lead to a decrease in 6C IPD in adults thereafter. © 2014 Janoir et al.

Kempf M.,Limoges University Hospital Center | Varon E.,Center National Of Reference Des Pneumocoques Cnrp | Lepoutre A.,Institute of Veille Sanitaire | Gravet A.,Limoges University Hospital Center | And 27 more authors.
Clinical Microbiology and Infection | Year: 2015

Streptococcus pneumoniae is an important cause of acute otitis media (AOM). The aim of this study was to evaluate trends in antibiotic resistance and circulating serotypes of pneumococci isolated from middle ear fluid of French children with AOM during the period 2001-2011, before and after the introduction of the PCV-7 (2003) and PCV-13 (2010) vaccines. Between 2001 and 2011 the French pneumococcal surveillance network analysed the antibiotic susceptibility of 6683 S.pneumoniae isolated from children with AOM, of which 1569 were serotyped. We observed a significant overall increase in antibiotic susceptibility. Respective resistance (I+R) rates in 2001 and 2011 were 76.9% and 57.3% for penicillin, 43.0% and 29.8% for amoxicillin, and 28.6% and 13.0% for cefotaxime. We also found a marked reduction in vaccine serotypes after PCV-7 implementation, from 63.0% in 2001 to 13.2% in 2011, while the incidence of the additional six serotypes included in PCV-13 increased during the same period, with a particularly high proportion of 19A isolates. The proportion of some non-PCV-13 serotypes also increased between 2001 and 2011, especially 15A and 23A. Before PCV-7 implementation, most (70.8%) penicillin non-susceptible pneumococci belonged to PCV-7 serotypes, whereas in 2011, 56.8% of penicillin non-susceptible pneumococci belonged to serotype 19A. Between 2001 and 2011, antibiotic resistance among pneumococci responsible for AOM in France fell markedly, and PCV-7 serotypes were replaced by non-PCV-7 serotypes, especially 19A. We are continuing to assess the impact of PCV-13, introduced in France in 2010, on pneumococcal serotype circulation and antibiotic resistance. © 2014 European Society of Clinical Microbiology and Infectious Diseases.

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