Epidemiology, Nasopharyngeal Carriage, Serotype Prevalence, and Antibiotic Resistance of Streptococcus pneumoniae in Indonesia

Abstract

In Indonesia, pneumococcal disease represents a considerable public health concern; however, published data on the epidemiology, nasopharyngeal carriage, serotype prevalence, and antibiotic resistance of Streptococcus pneumoniae in this region are limited. Therefore, this article reviews the available data from a variety of sources and also summarizes pneumococcal conjugate vaccine implementation and recommendations in Indonesia and subsequent impact on pneumococcal disease. Regional pneumococcal vaccination recommendations in Asia were also reviewed. Studies showed that pneumococcal nasopharyngeal carriage prevalence in Indonesia was approximately 43% to 55% in healthy children aged less than 5 years, which varied by age group, region, and year. Serotype analysis of pneumococcal nasopharyngeal carriage isolates in Indonesia revealed that 38% to 60% of isolates would be covered by the 13-valent pneumococcal conjugate vaccine (PCV13). The antimicrobial resistance of pneumococcal disease has increased over time; between 1997 and 2012, resistance to penicillin and sulfamethoxazole increased from 0% to 28% and 9% to 62%, respectively. Inclusion of pneumococcal conjugate vaccines into immunization programs is being implemented gradually. In 2017, Indonesia implemented a regional PCV13 immunization program in Lombok with a 2 + 1 vaccination schedule that was expanded in 2018–2019 to West Nusa Tenggara and Bangka Belitung Provinces; this expansion is predicted to substantially reduce the burden of pneumococcal disease in Indonesia. Overall, the limited data available regarding pneumococcal disease in Indonesia highlight the unmet need for comprehensive disease surveillance studies in this region that can help direct vaccination strategies.

Nasopharyngeal carriage rates and serotype distribution of Streptococcus pneumoniae among school children with acute otitis media in Central Java, Indonesia

“…In this study, we found that nasopharyngeal carriage rates of S. pneumoniae were high in primary school children with AOM (73 %), between the ages of 6 and 12, in Indonesia. In general, the incidence of nasopharyngeal carriage among Indonesian children is 55 % (ranging from 31.2–84.5%) [ 20 ]. Another study in aboriginal children vaccinated with pneumococcal vaccines showed that nasopharyngeal carriage rates were high (approximately 77.9 %) in them, with more than half of the children exhibiting otitis media symptoms [ 11 ].…”

“…Currently, there are limited data on nasopharyngeal carriage of S. pneumoniae in children with AOM in Indonesia. Since 2017, Indonesia has implemented a regional PCV immunization programme in selected regions [20]. In general, the nasopharyngeal carriage rate of S. pneumoniae is approximately 43-55 % in Indonesian children [20][21][22][23][24][25].…”

“…Since 2017, Indonesia has implemented a regional PCV immunization programme in selected regions [20]. In general, the nasopharyngeal carriage rate of S. pneumoniae is approximately 43-55 % in Indonesian children [20][21][22][23][24][25]. In this study, we investigated nasopharyngeal carriage rates and serotype distributions of S. pneumoniae among school children with AOM in the Banyumas Regency, Central Java, Indonesia during the period of 2018-2019, prior to the introduction of PCV.…”

“…pneumoniae in children with AOM in Indonesia. Since 2017, Indonesia has implemented a regional PCV immunization programme in selected regions [20]. In general, the nasopharyngeal carriage rate of S.…”

“…In general, the nasopharyngeal carriage rate of S. pneumoniae is approximately 43–55 % in Indonesian children [20–25]. In this study, we investigated nasopharyngeal carriage rates and serotype distributions of S.…”