Clinical Implications of Pneumococcal Serotypes: Invasive Disease Potential, Clinical Presentations, and Antibiotic Resistance.
- Author:
Joon Young SONG
1
;
Moon H NAHM
;
M Allen MOSELEY
Author Information
- Publication Type:Review
- Keywords: Streptococcus pneumoniae; Polysaccharides, Bacterial; Bacterial Capsules; Serotyping; Pneumococcal Infections
- MeSH: Drug Resistance, Multiple, Bacterial; Empyema/etiology; Hemolytic-Uremic Syndrome/etiology; Humans; Meningitis/etiology; Peritonitis/etiology; Pneumococcal Infections/complications/*immunology; Pneumonia, Pneumococcal/immunology; Serotyping; Streptococcus pneumoniae/*classification/pathogenicity
- From:Journal of Korean Medical Science 2013;28(1):4-15
- CountryRepublic of Korea
- Language:English
- Abstract: Streptococcus pneumoniae can asymptomatically colonize the nasopharynx and cause a diverse range of illnesses. This clinical spectrum from colonization to invasive pneumococcal disease (IPD) appears to depend on the pneumococcal capsular serotype rather than the genetic background. According to a literature review, serotypes 1, 4, 5, 7F, 8, 12F, 14, 18C, and 19A are more likely to cause IPD. Although serotypes 1 and 19A are the predominant causes of invasive pneumococcal pneumonia, serotype 14 remains one of the most common etiologic agents of non-bacteremic pneumonia in adults, even after 7-valent pneumococcal conjugate vaccine (PCV7) introduction. Serotypes 1, 3, and 19A pneumococci are likely to cause empyema and hemolytic uremic syndrome. Serotype 1 pneumococcal meningitis is prevalent in the African meningitis belt, with a high fatality rate. In contrast to the capsule type, genotype is more closely associated with antibiotic resistance. CC320/271 strains expressing serotype 19A are multidrug-resistant (MDR) and prevalent worldwide in the era of PCV7. Several clones of MDR serotype 6C pneumococci emerged, and a MDR 6D clone (ST282) has been identified in Korea. Since the pneumococcal epidemiology of capsule types varies geographically and temporally, a nationwide serosurveillance system is vital to establishing appropriate vaccination strategies for each country.
