Before PCV7 introduction, invasive pneumococcal disease (IPD) was responsible for approximately 12,000-18,000 deaths annually among children <5years in Latin America. In Peru, PCV7 was introduced in 2009. We used whole genome sequencing to deduce key features of invasive strains collected in Lima, Peru from 2006 to 2011. We sequenced 212 IPD isolates from 16 hospitals in Lima pre (2006-2009; n=133) and post (2010-2011; n=79) PCV7 introduction; 130 (61.3%) isolates were from children≤5years old. CDC's Streptococcus lab bioinformatics pipeline revealed serotypes, sequence types (STs), pilus genes, PBP types and other resistance determinants. During the pre-PCV7 period, serotype 14 was the most common serotype (24.8%), followed by 6B (20.3%), 19F (10.5%), and 23F (6.8%). Post-PCV7, the proportion of PCV7 serotype 6B decreased significantly (to 6.3%), while 19F (16.3%), 14 (15.0%), 23F (7.5%), and 19A (7.5%) were the most common serotypes; only serotypes 3 and 10A increased significantly. Overall, 82% (n=173) of all isolates carried at least one resistance determinant, including 72 (34%) isolates that carried resistance determinants against 3 or more antimicrobial classes; of these 72 isolates, 56 (78%) belonged to a PCV7 serotype. Eighty-two STs were identified, with 53 of them organized in 14 clonal complexes. ST frequencies were distributed differently pre and post-PCV7 introduction, with only 18 of the 57 STs identified in years 2006-2009 isolates also observed in years 2010-2011 isolates. The apparent expansion of a 19F/ST1421 lineage with predicted β-lactam resistance (PBP type 13:16:20) and carrying resistance determinants against four additional antimicrobial classes was observed.

中文翻译：

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通过全基因组测序确定了在秘鲁利马回收的侵袭性肺炎球菌分离株的关键特征。

在引入PCV7之前，在拉丁美洲5岁以下的儿童中，侵入性肺炎球菌疾病（IPD）每年导致大约12,000-18,000人死亡。在秘鲁，PCV7于2009年引入。我们使用全基因组测序推论了2006年至2011年在秘鲁利马收集的侵袭性菌株的关键特征。我们对来自利马前16家医院的212种IPD分离株进行了测序（2006-2009； n = 133）。 ）和发布（2010-2011； n = 79）PCV7简介；130株（61.3％）分离株来自5岁以下的儿童。CDC的链球菌实验室生物信息学渠道揭示了血清型，序列类型（ST），菌毛基因，PBP类型和其他抗性决定因素。在PCV7之前的时期，血清型14是最常见的血清型（24.8％），其次是6B（20.3％），19F（10.5％）和23F（6.8％）。PCV7后，PCV7 6B血清型的比例显着下降（降至6.3％），而最常见的血清型为19F（16.3％），14（15.0％），23F（7.5％）和19A（7.5％）；仅血清型3和10A显着增加。总体而言，所有分离株中有82％（n = 173）带有至少一种抗性决定簇，包括72种（34％）分离株带有对3种或更多种抗菌素的抗性决定簇。在这72个分离株中，有56个（78％）属于PCV7血清型。鉴定出82个ST，其中53个组织为14个克隆复合体。在引入PCV7前后，ST频率的分布不同，在2006-2009年分离株中鉴定出的57个ST中，只有18个在2010-2011年分离株中也观察到。具有预测的β-内酰胺抗性的19F / ST1421谱系的表观扩增（PBP类型13:16：