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Journal of Clinical Microbiology, June 2006, p. 2032-2038, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00275-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Distribution and Invasiveness of Streptococcus pneumoniae Serotypes in Switzerland, a Country with Low Antibiotic Selection Pressure, from 2001 to 2004

Andreas Kronenberg,1 Phillip Zucs,2 Sara Droz,1 and Kathrin Mühlemann1,3*

Institute for Infectious Diseases, University Bern, CH-3010 Bern, Switzerland,1 Federal Office of Public Health, Bern, Switzerland,2 Department for Infectious Diseases, University Hospital Bern, Bern, Switzerland3

Received 8 February 2006/ Returned for modification 17 March 2006/ Accepted 27 March 2006

To describe the serotype-specific epidemiology of colonizing and invasive Streptococcus pneumoniae isolates, which is important for vaccination strategies, we analyzed a total of 2,388 invasive and 1,540 colonizing S. pneumoniae isolates collected between January 2001 and December 2004 within two nationwide surveillance programs. We found that the relative rank orders of the most frequent serotypes (serotypes 1, 3, 4, 6B, 7F, 14, 19F, and 23F) differed among invasive and colonizing isolates. Serotypes 1, 4, 5, 7F, 8, 9V, and 14 had increased invasive potential, and serotypes/serogroups 3, 6A, 7, 10, 11, 19F, and 23F were associated with colonization. The proportion of pediatric serotypes was higher among children <5 years old (48.5%) and persons >64 years old (34.1%) than among other age groups (29.1%); it was also higher in West Switzerland (40.2%) than in other geographic regions (34.7%). Likewise, serotype-specific proportions of penicillin-resistant isolates for types 6B, 9V, 14, and 19F were significantly higher in West Switzerland. The relative frequency of pediatric serotypes corresponded with antibiotic consumption patterns. We conclude that the epidemiology of invasive and colonizing S. pneumoniae isolates is influenced by the serotype-specific potential for invasiveness, and therefore, surveillance programs should include colonizing and invasive S. pneumoniae isolates. Antibiotic selection pressure determines the serotype distribution in different age groups and geographic regions and therefore the expected direct and indirect effects of the 7-valent conjugate vaccine.

* Corresponding author. Mailing address: Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010 Bern, Switzerland. Phone: 41 31 632 32 59. Fax: 41 31 632 87 66. E-mail: kathrin.muhlemann{at}ifik.unibe.ch.

Journal of Clinical Microbiology, June 2006, p. 2032-2038, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00275-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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