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Journal of Clinical Microbiology, April 2009, p. 1012-1020, Vol. 47, No. 4
0095-1137/09/$08.00+0     doi:10.1128/JCM.01454-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Temporal Trends of Invasive Streptococcus pneumoniae Serotypes and Antimicrobial Resistance Patterns in Spain from 1979 to 2007{triangledown}

A. Fenoll,1 J. J. Granizo,3 L. Aguilar,2 M. J. Giménez,2 L. Aragoneses-Fenoll,1 G. Hanquet,4 J. Casal,1 and D. Tarragó1*

National Center for Microbiology, Instituto de Salud Carlos III, ctra. Majadahonda-Pozuelo Km. 2, Majadahonda, Madrid, Spain,1 Microbiology Department, School of Medicine, Universidad Complutense, Avda. Complutense s/n, Madrid, Spain,2 Granadatos SL, c/ Demetrio de la Guerra 4, Pozuelo de Alarcón, Madrid, Spain,3 Scientific Institute of Public Health, rue J Wytsman 14, Brussels, Belgium4

Received 29 July 2008/ Returned for modification 30 July 2008/ Accepted 11 February 2009

Temporal trends of serotypes from invasive pneumococcal disease (IPD) in Spain from 1979 to September 2007 under antibiotic and vaccine pressure were analyzed. A significant trend in pneumococcal conjugate 7-valent vaccine (PCV7) serotypes (except serotype 4) was found, whereby the prevalence increased from the early 1980s and decreased in the 2000s for all but serotype 23F, which began decreasing in the late 1980s. Among the major non-PCV7 serotypes, a significant decrease was observed for serotypes 1, 5, and 7F in the 1980s. From the late 1990s, serotypes 1, 5, 6A, 7F, and 19A increased significantly, while serotypes 3 and 8 showed similar but nonsignificant trends over time. The incidence of IPD cases was 10.7/100,000 for the period 1996 to 2006, with reporting coverage ranging from 18% to 43%. A significant decrease in IPD incidence due to PCV7 serotypes was observed, while the incidence of non-PCV7 serotypes increased, with the consequence that there was no clear pattern in the overall incidence of IPD. Penicillin nonsusceptibility was correlated with the proportion of PCV7 serotypes. Erythromycin nonsusceptibility increased in association with long-half-life macrolide consumption and then decreased in 2004 to 2007. The increase in PCV7 serotypes and antibiotic nonsusceptibility related to antibiotic consumption in the 1980s and 1990s was reversed in the 2000s, probably as a result of PCV7 immunization. The decrease in IPD incidence due to PCV7 serotypes was mirrored by an increase in that of non-PCV7 serotypes. The impact of various preventive/therapeutic strategies on pneumococcal evolution is serotype dependent, and the dynamics remain unpredictable.

* Corresponding author. Mailing address: Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda-Pozuelo Km. 2, 28220 Majadahonda, Madrid, Spain. Phone: 34 918 223620. Fax: 34 915 097966. E-mail: davtarrago{at}isciii.es

{triangledown} Published ahead of print on 18 February 2009.

Journal of Clinical Microbiology, April 2009, p. 1012-1020, Vol. 47, No. 4
0095-1137/09/$08.00+0     doi:10.1128/JCM.01454-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Fenoll, A., Gimenez, M.-J., Vicioso, M.-D., Granizo, J.-J., Robledo, O., Aguilar, L. (2009). Susceptibility of pneumococci causing meningitis in Spain and prevalence among such isolates of serotypes contained in the 7-valent pneumococcal conjugate vaccine. J Antimicrob Chemother 64: 1338-1340 [Full Text]  
  • Ardanuy, C., Rolo, D., Fenoll, A., Tarrago, D., Calatayud, L., Linares, J. (2009). Emergence of a multidrug-resistant clone (ST320) among invasive serotype 19A pneumococci in Spain. J Antimicrob Chemother 64: 507-510 [Abstract] [Full Text]  


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