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Objective. To estimate the prevalence of S. pneumoniae serotypes in adults aged of 18 years and older, including healthy carriers and patients with acute otitis media (AOM), community-acquired pneumonia (CAP) and invasive pneumococcal infection (IPI). Materials and Methods. A total of 230 isolates of S. pneumoniae from 10 centers were included in the study from 01.06.2019 to 01.10.2019. Re-identification and typing using real-time PCR with 22 primer pairs were performed in the central laboratory (Institute of Antimicrobial Chemotherapy, Russia). Results. In healthy nasopharyngeal carriers (n = 31), the following serotypes of S. pneumoniae were detected: 19F (29.0%), 6А/В (22.6%), 3 (16.1%), 11A/D and 23F (9.7% each), 23A (6.4%), 14 and 15A/F (3.2% each); PCV-13 and PPV-23 covered 80.6% and 90.3% of those serotypes, respectively. In patients with AOM (n = 18), serotypes were: 3 (16.7%), 11A/D and 6A/B (11.1%, each), 16, 19А, 19F, 23F, 7A/F (5.55%, each); PCV-13 and PPV-23 covered 50% and 61.1% of those serotypes, respectively. Among 166 isolates from patients with CAP, the following serotypes were detected: 3 (12.0%), 19F and 6A/B (10.2%, each), 14 and 11A/D (5.4% each), 15A/F and 23A (4.8% each), 9N/L (4.2%), 18 and 22A/F (2.4% each), 19A and 23F (1.8% each), 16, 9V/A (1.2% each), 4 and 33A/33F/37 (0.6% each), non-vaccine serotypes (30.3%); PCV-13 and PPV-23 covered 45.6% and 57.0% of those serotypes, respectively. Isolates from patients with IPI (n=15) belonged to the following serotypes: 3 (26.7%), 12F, 23F and 9N/L (13.3% each), serotypes 4 and 15A/F (6.7%), non-vaccine serotype – 1 isolate (6.7%); PCV-13 and PPV-23 covered 46.7% and 73.3% of those serotypes, respectively. Conclusions. The majority of S. pneumoniae serotypes in adult population in Russia are included in PPV-23, but not in PCV-13 (primarily due to serotype 11A/D). There was a high PCV-13 and PPV-23 coverage of serotypes from healthy nasopharyngeal carriers. PPV-23 covered more than 60% of clinical isolates, whereas PCV-13 covered less than 60% (AOM – 50.0%, CAP – 45.6%, IPI – 46.7%), thus indicating a potentially lower efficacy of PCV-13 in adult population.

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The paper presents optimized methods for PCR and sequence typing of Streptococcus pneumoniae. The serotype composition of pneumococci isolated from children under 5 years of age with infections of the upper respiratory tract was analyzed using optimized methods. Between 2016 and 2021, there was a decrease in the frequency of serotypes included in the pneumococcal 13-valent conjugate vaccine (PCV13) from 94.1 to 25.8%, mainly due to the 6ABCD serogroup and the 19F serotype. The coverage of serotypes circulating in children with PCV15 and PCV20 vaccines was 28.1% and 41.6% in 2021, respectively. During the study period, the number of non-vaccine serogroups 11AD and 15AF, as well as serotypes that are not detected under this capsular PCR typing protocol, increased most significantly.