Evolution of antimicrobial resistance and serotype distribution of Streptococcus pneumoniae isolated from children with invasive and noninvasive pneumococcal diseases in Algeria from 2005 to 2012

Abstract

Pneumococcal infections are a major cause of morbidity and mortality in developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has dramatically reduced the incidence of pneumococcal diseases. PCVs are not currently being used in Algeria. We conducted a prospective study from 2005 to 2012 in Algeria to determine antimicrobial drug resistance and serotype distribution of Streptococcus pneumoniae from children with pneumococcal disease. Among 270 isolated strains from children, 97 (36%) were invasive disease; of these, 48% were not susceptible to penicillin and 53% not susceptible to erythromycin. A high rate of antimicrobial nonsusceptibility was observed in strains isolated from children with meningitis. The serotype distribution from pneumococci isolated from children with invasive infections was (by order of prevalence): 14, 1, 19F, 19A, 6B, 5, 3, 6A and 23F. Multidrug resistance was observed in serotypes 14, 19F, 19A and 6B. The vaccine coverage of serotypes isolated from children aged <5 years was 55.3% for PCV7, 71.1% for PCV10 and 86.8% for PCV13. Our results highlight the burden of pneumococcal disease in Algeria and the increasing S. pneumoniae antibiotic resistance. The current pneumococcal vaccines cover a high percentage of the circulating strains. Therefore, vaccination would reduce the incidence of pneumococcal disease in Algeria.

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

“…29,37,43,45 The most common serotypes causing invasive disease (12,896 isolates) were serotype 14 (16.7%), followed by serotypes 6B and 6A (14.1% and 12.6%, respectively), serotype 23F (12.0%), and serotypes 19F and 19A (10.7% and 7.6% respectively; Figure 4). The most common serotypes identified in noninvasive studies were 19B/C/F (20.4%), nontypeable/serotypes of unknown designation (16.8%), 6/A/B (15.6%), and serotype 14 (11.7%).…”

“…In 21 studies 14,17,20,23,27,30,31,37,38,43,44,52–59,61,62 representing 11,486 isolates (of which 82.0% were from Southern Africa) 23,57,62 , the pooled prevalence of penicillin susceptibility was 78.1% (95% CI 61.9, 89.2). The change in minimum inhibitory concentration breakpoints instituted by CLSI in 2008 14,20,30,31,37,38,53–55,57,59,61,63 yielded susceptibilities of 82.5% (95% CI 60.7, 94.1) pre-CLSI 14,17,20,30,31,37,38,53–55,57,59,61 and 69.0% (95% CI 42.6, 88.4) post-CLSI.…”

“…The change in minimum inhibitory concentration breakpoints instituted by CLSI in 2008 14,20,30,31,37,38,53–55,57,59,61,63 yielded susceptibilities of 82.5% (95% CI 60.7, 94.1) pre-CLSI 14,17,20,30,31,37,38,53–55,57,59,61 and 69.0% (95% CI 42.6, 88.4) post-CLSI. 23,43,52,56,58,62 Overall susceptibilities to beta-lactam antibiotics were high: ampicillin/amoxicillin 94.7% (95% CI 80.2, 99.4) 17,30,38,42,43,54,55,57,59,60 and third-generation cephalosporins 98.5% (95% CI 95.1, 100.0). 17,30,42,52,54,56,58–61 .…”

Whole Genome Sequencing of 39 Invasive Streptococcus pneumoniae Sequence Type 199 Isolates Revealed Switches from Serotype 19A to 15B

“…In addition to the seven serotypes in PCV7, this vaccine contains the most frequent replacement serotypes [16, 17] and serotypes with high prevalence in the developing world [5, 18] (1, 3, 5, 7F, 6A and 19A), which has led to an additional 94% reduction in IPD caused by those 13 vaccine serotypes [7, 19]. Currently, increased rates of IPD by serogroup 15B/C, which is predominantly associated with ST199, can be observed in some countries [20].…”

13 Valanlı Konjuge Pnömokok Aşısı ile Aşılanmış Bir Çocuk Olguda Streptococcus pneumoniae Serotip 24A’ya Bağlı Gelişen Menenjit

“…Gant ve arkadaşları İspanya'da 2009-2010 yılları arasında invaziv hastalığa neden olan 285 S. pneumoniae suşu topladı ve 24A serotipi sadece bir olguda belirlendi (4). Cezayir'de yapılan çocuklardan izole edilen S. pneumoniae serotip dağılımını değerlendiren bir çalışmada, 24A serotipinden kaynaklanan sadece bir noninvaziv pnömokok hastalığı (alt solunum yolu enfeksiyonu) bildirildi (5). Literatür araştırmamızda etyolojik ajan olarak 24A serotipini gösteren başka bir çalışma bulunamamıştır.…”