PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

Abstract

Introduction: To determine the phenotypes and genotypes of invasive Streptococcus pneumoniae (S. pneumoniae), 108 strains were isolated from paediatric patients with invasive pneumococcal diseases (IPDs) in Shenzhen from 2014 to 2018. Methods: Serotype profiles were defined by multiplex PCR of the capsule gene. Pneumococcal surface protein A (PspA) classification was performed through pspA gene sequencing. Antimicrobial resistance was examined by broth microdilution. Multilocus sequence typing (MLST) was determined based on next-generation sequencing data. Results: Eighty-one S. pneumoniae of 17 serotypes were finally collected. The coverage of the 13-conjugated polysaccharide vaccine (PCV13) was 88.9%. After the introduction of PCV13, the nonvaccine serotypes were added by serotypes 15b, 16F and 20. Vaccine serotype 3 increased by four serious cases. The pspA family 1 and pspA family 2 are predominant. The multiple drug resistance rate is 91.3%. None of the nonmeningitis isolates were resistant to penicillin, while 98.8% of all the isolates were resistant to erythromycin. Discussion: This work characterizes the molecular epidemiology of invasive S. pneumoniae in Shenzhen. Continued surveillance of serotype distribution and antimicrobial susceptibility is necessary to alert antibiotic-resistant nonvaccine serotypes and highly virulent serotypes.

Characterization of Streptococcus pneumoniae Macrolide Resistance and Its Mechanism in Northeast China over a 20-Year Period

“…In addition, the total rate of detection of mefA was 57.74%, whereas that of the M phenotype was only 0.97%. The results of this study are consistent with those of previous and recent studies in China, with a predominance of the cMLSB phenotype and a few strains of the M phenotype ( 18 , 24 , 26 ). ermTR was not detected in this study, suggesting that macrolide resistance is not associated with it in northeastern China.…”

A Jack of All Trades: The Role of Pneumococcal Surface Protein A in the Pathogenesis of Streptococcus pneumoniae

“…Although there are differences in the proportions of the distribution of PspA families in different populations in the world, the vast majority are composed predominantly of families 1 and 2 ( Table 2 and Figure 4 ). Pneumococcal isolates from pediatric patients, including from middle ear fluid or nasopharyngeal secretions, reveal that the majority of PspA proteins fall into either family 2 or family 1 ( Vela Coral et al., 2001 ; Mollerach et al., 2004 ; Melin et al., 2008 ; Jiang et al., 2021 ). While in adults over 50 years of age, differences in the PspA family distribution show that the majority (> 50-55%) of PspA proteins are in family 2 ( Hollingshead et al., 2006 ).…”

Intranasal bivalent vaccine with recombinant Influenza Virus expressing Pneumococcal Surface Protein A (PspA) protects against Streptococcus pneumoniae and Influenza A virus infection in mice

“…It is expressed in signi cant and constant quantities during colonization, carriage, and invasive disease, and its surface exposure (protruding beyond the capsule) allows e cient antibody binding 39,40 . Based on its variability in different isolates, PspA has been sequence-based classi ed into three families, that are subdivided into six clades: family 1 (clades 1 and 2), family 2 (clades 3, 4 and 5) and family 3 (clade 6), with 90% of all clinically isolated pneumococcal strains isolated belonging to families 1 and 2 [41][42][43][44][45][46][47] . Despite these variations, PspA antibodies are highly crossreactive, especially in the same family [48][49][50] .…”