Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae strains in the south of Tunisia: A five-year study (2012–2016) of pediatric and adult populations. (December 2017)

• Record Type: Journal Article
• Authors: Ktari, Sonia; Jmal, Ikram; Mroua, Manel; Maalej, Sonda; Ben Ayed, Nour ElHouda; Mnif, Basma; Rhimi, Faouzia; Hammami, Adnene
• Is Part Of: International journal of infectious diseases. Volume 65(2017:Dec.)
• Page Start: 110
• Page End: 115
• Publication Date: 2017-12
• Subjects: Streptococcus pneumoniae -- Antibiotic -- Serotype -- PCV -- Tunisia; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2017.10.015
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: A few reports on pneumococcal serotypes from Tunisia have been published in the last decade. Serotype distribution and drug resistance patterns of invasive and non-invasive pediatric and adults pneumococcal isolates. None of the PCVs is currently part of the national immunization program for childhood vaccination in Tunisia. The rate of pneumococcal strains with resistance to both penicillin and macrolides is alarming. Vaccine serotypes still persist among the population, which could be related to low vaccine uptake. Abstract: Objectives: To analyze the serotype distribution of Streptococcus pneumoniae clinical isolates collected in the south of Tunisia over a 5-year period in different age groups and to assess their antimicrobial susceptibility patterns. Methods: A total of 305 non-duplicate S . pneumoniae isolates were collected between January 2012 and December 2016 at the university hospital in Sfax, Tunisia. All isolates were serotyped by multiplex PCR. The antibiotic susceptibility of all isolates was determined using the disk diffusion test or Etest assay. Results: Among the 305 pneumococcal isolates, 76 (24.9%) were invasive and 229 (75.1%) were non-invasive. The most common serotypes were 19F (20%), 14 (16.7%), 3 (9.2%), 23F (7.5%), 19A (5.9%), and 6B (5.9%). Potential immunization coverage rates for pneumococcal conjugate vaccines PCV7, PCV10, and PCV13 were 58%, 59.3%, and 78.7%, respectively. Three-quarters (75.3%) of pneumococcal isolates were non-susceptible to penicillin. The resistance rate to erythromycin was 71.4%. Only two isolates were resistant to levofloxacin. Conclusions: 19F and 14 were the most prevalent serotypes in the south of Tunisia. The inclusion of a PCV in the immunization program could be useful for reducing the burden of pneumococcal diseases. The high resistance rate to penicillin and macrolides is alarming. Prudent use of antibiotics is crucial to prevent the selection of multidrug-resistant pneumococci.