Genetic diversity of Streptococcus pneumoniae in Tunisia

Midouni, Basma; Mehiri, Emna; Ghariani, Asma; Draoui, Henda; Essalah, Leila; Bouzouita, Imen; Raoult, Didier; Slim-Saidi, Leila; Fournier, Pierre‐Edouard

doi:10.1016/j.ijantimicag.2018.09.023

Cited by 7 publications

(3 citation statements)

References 36 publications

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“…cMLSB phenotype is predominant in most European countries and particularly in France, Spain, and Switzerland, whereas the M phenotype predominates in North America, England, and Germany [ 36 ]. According to recent studies, the cMLSB phenotype was the most frequent in Tunisia (75.5%) [ 45 ]. The macrolide-resistant phenotypes were genotypically confirmed by the presence of erm B (87.5%) and mef E (10.9%) genes.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018

et al. 2023

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Background Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide. In this study, we sought to analyze serotype distributions, antibiotic resistance, and genetic relationships of 106 clinical invasive pneumococcal isolates recovered in Tunisia between 2012 and 2018, prior to the routine use of pneumococcal conjugate vaccines (PCV). Methods We used multiplex PCR, the disk diffusion method and/or E-test, and multi-locus sequence typing (MLST). Results The most frequent serotypes were 14 (17%), 19F (14.2%), and 3 (11.3%). Of the 106 S. pneumoniae isolates, 67.9% were penicillin non-susceptible (29.4% were resistant), 45.3% were amoxicillin non-susceptible (17% were resistant), and 16% were cefotaxime non-susceptible. For antibiotics other than β-lactams, resistance rates to erythromycin, tetracycline, cotrimoxazole, and chloramphenicol were 62.3, 33, 22.6, and 4.7%, respectively. Two isolates were non-susceptible to levofloxacin. Among 66 erythromycin-resistant pneumococci, 77.3% exhibited the cMLSB phenotype, and 87.9% carried ermB gene. All tetracycline-resistant strains harbored the tetM gene. The potential coverage by 7-, 10-, and 13-valent pneumococcal conjugate vaccines were 55.7, 57.5, and 81.1%, respectively. A multilocus sequence typing analysis revealed great diversity. Fifty different sequence types (STs) were identified. These STs were assigned to 10 clonal complexes and 32 singletons. The most common STs were 179, 2918, 386, and 3772 – related mainly to 19F, 14, 6B/C, and 19A serotypes, respectively. Conclusions This study demonstrated that the majority of the serotypes of invasive pneumococci in the Tunisian population were 14, 19F, and 3. Moreover, we noted a high degree of genetic diversity among invasive S. pneumoniae isolates. The highest proportions of antibiotic non-susceptible isolates were for penicillin, erythromycin, and tetracycline. Further molecular characteristics are required to monitor the genetic variations and to follow the emergence of resistant pneumococci for the post-vaccination era in Tunisia.

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Section: Discussionmentioning

confidence: 99%

Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018

et al. 2023

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“…Fifteen out of the 141 isolates were of serotype 19A, bearing resistance to penicillin and ERY. The most frequent 19A ST was ST3772 [61].…”

Section: Africamentioning

confidence: 99%

Circulating Clonal Complexes and Sequence Types of Streptococcus Pneumoniae Serotype 19a Worldwide: The Importance of Multidrug Resistance: A Systematic Literature Review

García

Guevara²,

Izurieta

et al. 2021

Expert Review of Vaccines

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Introduction: Streptococcus pneumoniae is a major cause of morbidity and mortality, especially amongst young children and the elderly. Childhood implementation of pneumococcal conjugate vaccines (PCVs) significantly reduced the incidence of invasive pneumococcal disease (IPD), while several non-vaccine serotypes remained substantial.Although there is evidence of the impact of higher-valent PCVs on serotype 19A, 19A IPD burden and antibiotic resistance remain a major concern post-vaccination. Areas covered:We performed a systematic literature review to analyze the frequency and clonal distribution of serotype 19A isolates in the pre-and post-PCV era worldwide providing a scientific background on the factors that influence multi-drug resistance in pneumococcal isolates.Expert opinion: Serotype 19A IPD incidence increased in all regions following the introduction of the 7-valent PCV. The higher-valent PCVs have reduced the rates of 19A IPD isolates, but several circulating strains with diverse antibiotic resistance prevailed.Heterogeneous clonal distribution in serotype 19A was observed within countries and regions, irrespective of higher-valent PCV used. Increase of 19A isolates from pre-to postvaccination periods was associated with frequently occurring serotype switching events and with the prevalence of multi-drug resistant strains. Rational antibiotic policies must be implemented to control the emergence of resistance.

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“…1; Table 3). Across these publications, data were provided for Algeria (n = 1) [43], Egypt (n = 5) [43][44][45][46][47], Iran (n = 2) [48,49], Kuwait (n = 3) [50][51][52], Lebanon (n = 3) [53][54][55], Morocco (n = 2) [43,56], Oman (n = 1) [57], Saudi Arabia (n = 2) [51,58], Tunisia (n = 6) [43,[59][60][61][62][63], Turkey (n = 5) [64][65][66][67][68], and Yemen (n = 1) [40].…”

Section: Streptococcus Pneumoniaementioning

confidence: 99%

The Burden of Invasive Vaccine-Preventable Diseases in Adults in the Middle East and North Africa (MENA) Region

et al. 2021

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Genetic diversity of Streptococcus pneumoniae in Tunisia

Cited by 7 publications

References 36 publications

Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018

Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018

Circulating Clonal Complexes and Sequence Types of Streptococcus Pneumoniae Serotype 19a Worldwide: The Importance of Multidrug Resistance: A Systematic Literature Review

The Burden of Invasive Vaccine-Preventable Diseases in Adults in the Middle East and North Africa (MENA) Region

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