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Genotypic and phenotypic characterisation of invasive Streptococcus pneumoniae isolates from Hungary, and coverage of the conjugate vaccines
  1. Orsolya Dobay1,
  2. Ágnes Ungvári1,
  3. Szilvia Kardos1,
  4. Katalin Kristóf1,2,
  5. Edit Hajdú3,
  6. Judit Szabó4,
  7. Márta Knausz5,
  8. Erzsébet Nagy3,
  9. Ferenc Rozgonyi1,6,
  10. Sebastian G B Amyes7,
  11. Károly Nagy1
  1. 1Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
  2. 2Division of Clinical Microbiology Diagnostics, Central Diagnostic Laboratory, Semmelweis University, Budapest, Hungary
  3. 3Department of Clinical Microbiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
  4. 4Department of Medical Microbiology, Medical and Health Centre, University of Debrecen, Hungary
  5. 5Aladár Petz County Teaching Hospital, Győr, Hungary
  6. 6Microbiology Laboratory, Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
  7. 7Centre for Infectious Diseases, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Sebastian G B Amyes, University of Edinburgh, Room SU.312, Centre for Infections Diseases, The Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK; s.g.b.amyes{at}


Background and aims The 7-valent conjugate pneumococcal vaccine (Prevenar) was introduced as a recommended (but not yet obligatory) vaccine in Hungary in April 2009 and there was a sharp increase in the number of children vaccinated. Hence there is an urgent need for in-depth epidemiological data on invasive pneumococci before vaccination becomes widespread. Such a study has never been done before in Hungary.

Methods 144 pneumococcal isolates, obtained from invasive infections or pneumonia, were collected from eight Hungarian diagnostic laboratories between 2000 and 2008. After confirmation of species identity, their susceptibilities to nine antibiotics were determined by Etest and agar dilution method. The serotypes and pulsed-field gel electrophoresis genotypes of the strains were also determined.

Results In this cohort, most of the isolates were from patients at the extreme of life. Only 1.4% of the strains were resistant to penicillin, but nearly 40% were resistant to erythromycin (mainly due to erm(B) gene). Higher incidences of resistance were found in the very young and very old. The most prevalent serotypes in the cohort in descending order were 14, 6A, 6, 6B, 23F, 3, 19F and 11A.

Conclusions Results showed a similar but not identical profile to previously examined strains causing pulmonary infections in Hungary. The serotypes could be correlated to patient groups. Furthermore, there were examples of serotype switching in strains showing identical genotype but different serotype. The study also shows a good coverage by the conjugate vaccines over the invasive pneumococcal strains in Hungary based on the detected serotypes.

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  • Funding This work was financially supported by the Hungarian National Scientific Research Fund (OTKA), grant numbers F61665 and PD75660.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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