Serotype Distribution and Antimicrobial Resistance of <i>Streptococcus pneumoniae</i> Causing Invasive Pneumococcal Disease in Korea Between 2017 and 2019 After Introduction of the 13-Valent Pneumococcal Conjugate Vaccine

Kim, Gyu Ri; Kim, Eun-Young; Kim, Si Hyun; Lee, Hae Kyung; Lee, Jaehyeon; Shin, Jong Hee; Kim, Young Ree; Song, Sae Am; Jeong, Joseph; Uh, Young; Kim, Yu Kyung; Yong, Dongeun; Kim, Hyo Soo; Kim, Sun Joo; Kim, Young Ah; Shin, Kyeong Seob; Jeong, Seok Hoon; Ryoo, Nam Hee; Shin, Jeong Hwan

doi:10.3343/alm.2023.43.1.45

Cited by 20 publications

(19 citation statements)

References 41 publications

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“…The increased macrolide resistance is likely due to the extensive use of macrolides, principally for community-acquired respiratory tract infections. Even higher rates of S. pneumoniae macrolide resistance have been reported in China (92.0%), Taiwan (89.1%), and Korea (80.3%) [ 32 33 34 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance of Streptococcus pneumoniae Clinical Serotypes between 2017 and 2022 in Crete, Greece

Maraki,

Mavromanolaki,

Stafylaki

et al. 2024

Infect Chemother

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Background Pneumococcal disease is still considered a global problem. With the introduction of pneumococcal conjugate vaccines (PCVs) serotype epidemiology changed, but antimicrobial resistance persists constituting a serious problem. The current study aimed to determine the serotype distribution and the antimicrobial susceptibility of recent Streptococcus pneumoniae isolates, following implementation of the 13-valent conjugate vaccine (PCV13). Materials and Methods From January 2017 to December 2022 we evaluated 116 nonduplicate S. pneumoniae isolates collected from adult patients (21 - 98 years) cared for in the University Hospital of Heraklion, Crete, Greece. Pneumococcal isolates were serotyped by the Quellung reaction, and antimicrobial susceptibility testing was performed using E-test. Multidrug resistance (MDR) was defined as non-susceptibility to at least one agent in ≥3 classes of antibiotics. Results Among the 116 isolates, 31% were recognized as invasive pneumococcal strains, while 69% were non-invasive. The isolates tested belonged to 25 different serotypes. The most prevalent serotypes were 11A (10.3%), and 35B (10.3%), followed by 3 (9.5%), 15A (7.8%), 25F (6.9%), 19A (5.3%), 35F (5.3%), and others (44.6%). The coverage rates of PCV13 and the pneumococcal polysaccharide vaccine (PPSV23) were 26.7% and 57.8%, respectively. PCV13 and PPSV23 serotypes decreased between 2017 - 2019 and 2020 - 2022, with a parallel increase in the non-vaccine types. Resistance rates to erythromycin, clindamycin, trimethoprim/sulfamethoxazole, penicillin, levofloxacin, and ceftriaxone, were 40.5%, 21.6%, 13.8%, 12.1%, 3.4%, and 0%, respectively. All isolates were susceptible to vancomycin, linezolid, and daptomycin. MDR was observed among 36 (31%) S. pneumoniae isolates. Conclusion The increasing levels of resistance in S. pneumoniae in Crete, Greece, highlight the need for continuous surveillance of antimicrobial resistance and development of strategies for its reduction, including antimicrobial stewardship programs, increased pneumococcal vaccination, and development of next generation PCVs with a wider serotype coverage.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance of Streptococcus pneumoniae Clinical Serotypes between 2017 and 2022 in Crete, Greece

Maraki,

Mavromanolaki,

Stafylaki

et al. 2024

Infect Chemother

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“…One of the most clinically relevant vaccines for S. pneumoniae is the pneumococcal conjugate vaccine PCV13. Yet, it covers only ~60% of the circulating serotypes in some Asian countries 66 , 67 . Therefore, an updated vaccine is needed.…”

Section: Discussionmentioning

confidence: 99%

The divisome but not the elongasome organizes capsule synthesis in Streptococcus pneumoniae

et al. 2023

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The bacterial cell envelope consists of multiple layers, including the peptidoglycan cell wall, one or two membranes, and often an external layer composed of capsular polysaccharides (CPS) or other components. How the synthesis of all these layers is precisely coordinated remains unclear. Here, we identify a mechanism that coordinates the synthesis of CPS and peptidoglycan in Streptococcus pneumoniae. We show that CPS synthesis initiates from the division septum and propagates along the long axis of the cell, organized by the tyrosine kinase system CpsCD. CpsC and the rest of the CPS synthesis complex are recruited to the septum by proteins associated with the divisome (a complex involved in septal peptidoglycan synthesis) but not the elongasome (involved in peripheral peptidoglycan synthesis). Assembly of the CPS complex starts with CpsCD, then CpsA and CpsH, the glycosyltransferases, and finally CpsJ. Remarkably, targeting CpsC to the cell pole is sufficient to reposition CPS synthesis, leading to diplococci that lack CPS at the septum. We propose that septal CPS synthesis is important for chain formation and complement evasion, thereby promoting bacterial survival inside the host.

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“…Similarly, in Brazil and Ethiopia, the introduction of PCV10 in 2010–2011 was associated with increased infection rates of non-PCV10 serotypes and decreased infection rates of PCV10 serotypes ( Berezin et al 2020 ; Sharew et al 2021 ). Conversely, in South Korea, the introduction of PCV13 in 2014 led to an increase in non-PCV13 serotypes, such as 10A, 34, 23A, 22F, 35b, and 11A among invasive S. pneumoniae strains responsible for invasive pneumococcal disease ( Kim et al 2023 ).…”

Section: Introductionmentioning

confidence: 99%

The Molecular Approaches and Challenges of Streptococcus pneumoniae Serotyping for Epidemiological Surveillance in the Vaccine Era

Abdul Rahman,

Mohd Desa,

Masri

et al. 2023

Polish Journal of Microbiology

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Streptococcus pneumoniae (pneumococcus) belongs to the Gram-positive cocci. This bacterium typically colonizes the nasopharyngeal region of healthy individuals. It has a distinct polysaccharide capsule – a virulence factor allowing the bacteria to elude the immune defense mechanisms. Consequently, it might trigger aggressive conditions like septicemia and meningitis in immunocompromised or older individuals. Moreover, children below five years of age are at risk of morbidity and mortality. Studies have found 101 S. pneumoniae capsular serotypes, of which several correlate with clinical and carriage isolates with distinct disease aggressiveness. Introducing pneumococcal conjugate vaccines (PCV) targets the most common disease-associated serotypes. Nevertheless, vaccine selection pressure leads to replacing the formerly dominant vaccine serotypes (VTs) by non-vaccine types (NVTs). Therefore, serotyping must be conducted for epidemiological surveillance and vaccine assessment. Serotyping can be performed using numerous techniques, either by the conventional antisera-based (Quellung and latex agglutination) or molecular-based approaches (sequetyping, multiplex PCR, real-time PCR, and PCR-RFLP). A cost-effective and practical approach must be used to enhance serotyping accuracy to monitor the prevalence of VTs and NVTs. Therefore, dependable pneumococcal serotyping techniques are essential to precisely monitor virulent lineages, NVT emergence, and genetic associations of isolates. This review discusses the principles, associated benefits, and drawbacks of the respective available conventional and molecular approaches, and potentially the whole genome sequencing (WGS) to be directed for future exploration.

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Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Causing Invasive Pneumococcal Disease in Korea Between 2017 and 2019 After Introduction of the 13-Valent Pneumococcal Conjugate Vaccine

Cited by 20 publications

References 41 publications

Antimicrobial Resistance of Streptococcus pneumoniae Clinical Serotypes between 2017 and 2022 in Crete, Greece

Antimicrobial Resistance of Streptococcus pneumoniae Clinical Serotypes between 2017 and 2022 in Crete, Greece

The divisome but not the elongasome organizes capsule synthesis in Streptococcus pneumoniae

The Molecular Approaches and Challenges of Streptococcus pneumoniae Serotyping for Epidemiological Surveillance in the Vaccine Era

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