Serotype Distribution and Drug Resistance in<i>Streptococcus pneumoniae</i>, Palestinian Territories

Kattan, Randa; Rayyan, Amal Abu; Zheiman, Inas; Idkeidek, Suzan; Baraghithi, Sabri; Rishmawi, Nabeel; Turkuman, Sultan; Abu-Diab, Afaf; Ghneim, Riyad; Zoughbi, Madeleine; Dauodi, Rula; Ghneim, Raed; Issa, Abed-El-Razeq; Siryani, Issa; Qas, Randa Al; Liddawi, Rawan; Khamash, Hatem; Kanaan, Moein; Marzouqa, Hiyam; Hindiyeh, Musa

doi:10.3201/eid1701.100886

Cited by 8 publications

(12 citation statements)

References 11 publications

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“…Congruently, results obtained from a carriage study on healthy Israeli children aged below 36 months showed the added benefit of an extended serotype coverage by the PCV13 vaccine over the PCV7 vaccine of 21%, raising it from 46% to 67% [40]. Employing the PCV13 vaccine increases the cross-protective spectrum, at least against strains of the serotypes 6A, 19A, 3 and 1, which were also mentioned by Kattan et al, and are also responsible for IPD among Palestinian children [20]. The results from testing antimicrobial susceptibility of the strains of S. pneumoniae isolated from the Palestinian children in relation to the strain's serotypes, as mentioned above and discussed below, also support recommending using the PCV13 vaccine in the NIP in the West Bank.…”

Section: Discussionmentioning

confidence: 86%

Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution and Antimicrobial Resistance

Nasereddin

Shtayeh²,

Ramlawi³

et al. 2013

PLoS ONE

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Infections of Streptococcus pneumoniae in children can be prevented by vaccination; left untreated, they cause high morbidity and fatalities. This study aimed at determining the nasopharyngeal carrier rates, serotype distribution and antimicrobial resistance patterns of S. pneumoniae in healthy Palestinian children under age two prior to the full introduction of the pneumococcal 7-valent conjugate vaccine (PCV7), which was originally introduced into Palestine in a pilot trial in September, 2010. In a cross sectional study, nasopharyngeal specimens were collected from 397 healthy children from different Palestinian districts between the beginning of November 2012 to the end of January 2013. Samples were inoculated into blood agar and suspected colonies were examined by amplifying the pneumococcal-specific autolysin gene using a real-time PCR. Serotypes were identified by a PCR that incorporated different sets of specific primers. Antimicrobial susceptibility was measured by disk diffusion and MIC methods. The resulting carrier rate of Streptococcus pneumoniae was 55.7% (221/397). The main serotypes were PCV7 serotypes 19F (12.2%), 23F (9.0%), 6B (8.6%) and 14 (4%) and PCV13 serotypes 6A (13.6%) and 19A (4.1%). Notably, serotype 6A, not included in the pilot trial (PCV7) vaccine, was the most prevalent. Resistance to more than two drugs was observed for bacteria from 34.1% of the children (72/211) while 22.3% (47/211) carried bacteria were susceptible to all tested antibiotics. All the isolates were sensitive to cefotaxime and vancomycin.Any or all of these might impinge on the type and efficacy of the pneumococcal conjugate vaccines and antibiotics to be used for prevention and treatment of pneumococcal disease in the country.

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Section: Discussionmentioning

confidence: 86%

Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution and Antimicrobial Resistance

Nasereddin

Shtayeh²,

Ramlawi³

et al. 2013

PLoS ONE

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“…In contrast, susceptibility to erythromycin and cotrimoxazole were lower at 68.3% and 38.3% respectively and serotype 14 was indeed responsible for majority (75%) of the less susceptible isolates from these two classes of antibiotics. This is further supported by the fact that 53.3% of serotype 14 isolates were resistant to two or more antibiotics [133].…”

Section: Palestinementioning

confidence: 83%

“…PCV7 coverage is estimated to be 55.0% (including serogroup 18) while PCV10 and PCV13 cover 77.5% and 85.0% of the isolates, respectively. The prevalence was predicted based on patients <11 years old suspected with sepsis or endocarditis, but no meningitis or pneumonia cases were included due to the rare occurrence of these infections in Palestine [133]. Overall, all were susceptible to vancomycin and almost all (98.3%) of the isolates were susceptible to penicillin and ofloxacin [133].…”

Section: Palestinementioning

confidence: 99%

“…The prevalence was predicted based on patients <11 years old suspected with sepsis or endocarditis, but no meningitis or pneumonia cases were included due to the rare occurrence of these infections in Palestine [133]. Overall, all were susceptible to vancomycin and almost all (98.3%) of the isolates were susceptible to penicillin and ofloxacin [133]. In contrast, susceptibility to erythromycin and cotrimoxazole were lower at 68.3% and 38.3% respectively and serotype 14 was indeed responsible for majority (75%) of the less susceptible isolates from these two classes of antibiotics.…”

Section: Palestinementioning

confidence: 99%

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Current Trend in Pneumococcal Serotype Distribution in Asia

Le¹,

Yusof²,

Sekaran³

2014

J Vaccines Vaccin

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Asia is one of the continents in the world heavily impacted by pneumococcal diseases but yet the information on disease burden and serotype distribution remained largely unclear. The data is essentially needed to inform the burden of pneumococcal diseases as a priority public health concern among the Asian countries. The formulations of pneumococcal conjugate vaccines (PCV) included a number of prevailing serotypes in the Western world but geographical and temporal variations of vaccination effectiveness could be expected in Asia. This review focuses specifically on the most recent five years trend in serotype distributions from both invasive and non-invasive pneumococcal diseases in Asia. Other important features such as antimicrobial resistance and associated clones were also noted. All latest studies reported that complied with the scopes of this review were included and the serotyping data were extracted for comparison analysis between countries, regions, and to represent Asia as the whole. The most common serotypes detected in highest to lowest frequencies order are 19F, 14, 23F, 6B, 19A, 3, and 6A, accounted for approximate two third of the incidences. Heptavalent PCV (PCV7) is expected to cover half of the incidences with significant increment in efficacy with PCV13. East Asia, Southeast Asia, and West Asia have relatively similar serotype distributions though slight variations were observed. The more unique pattern is noted in South Asia region. Initiation of surveillance study in countries with no reporting data is needed. Continued surveillance involving nationwide or multinational collaborative networks need to be set up to enhance and standardize the reporting incidences.

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“… 3 The management of streptococcal-related pneumonia is made more difficult by the appearance of several antimicrobial or resistant germs. 4 , 5 Therefore, the successful treatment of drug-resistant pneumococcal pneumonia represents a challenge for physicians. There is an association between the usage of antiseptic agents and the occurrence of resistance in S. pneumoniae .…”

Section: Introductionmentioning

confidence: 99%

The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumoniae

Yayan¹

2014

DDDT

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BackgroundCommunity-acquired pneumonia (CAP) is an acute inflammation of the lungs, which is often caused by Streptococcus pneumoniae. CAP is the leading cause of death by infectious disease in industrialized countries. Therefore, an immediate and effective antibiotic therapy is of great importance for the nonfatal outcome of the disease. The literature contains increasing data about the development of resistance to antibiotics that are used for the treatment of CAP caused by S. pneumoniae; this article also examines the possible development of resistance to antibiotics in S. pneumoniae in recent years.MethodsWithin the study period of 2004–2014, all hospital charts from patients with CAP caused by S. pneumoniae were collected from the Department of Internal Medicine, Saarland University Medical Center, Homburg/Saar, Germany. The tracheal secretions of S. pneumoniae in CAP patients were obtained by bronchoalveolar lavage; bronchial aspirates were obtained through flexible bronchoscopy and directly from sputum, and blood cultures were examined microbiologically for microorganisms.ResultsFrom a total of 100 patients with CAP caused by S. pneumoniae, 23 (53.49% [34.78% female], 95% confidence interval, 38.58–68.4) patients with a mean age of 59.78±15.77 years met the inclusion criteria of this investigation. These patients were compared to a total of 20 (46.51% [35% female], 95% confidence interval, 31.6–61.42) patients with a mean age of 58.9±13.36 years with CAP who were infested with S. pneumoniae. In the latter group, the streptococcal antigen was detected in pulmonary aspirations by bronchoscopy or in urine using polymerase chain reaction and a rapid pneumococcal test. Penicillin G and vancomycin had a high rate of sensitivity on the antibiogram for S. pneumoniae, which was obtained by bronchoalveolar lavage, bronchial aspirates through flexible bronchoscopy, and directly from sputum. Even though the rates obtained were without statistical significance, S. pneumoniae had a high resistance to macrolides, namely erythromycin, in patients with CAP. Macrolides, specifically erythromycin (17.39%) and azithromycin (4.35%) and other classes of antibiotics such as tetracycline (4.35%), had a statistically significant resistance to streptococcal pneumonia in patients with CAP (P=0.0009).ConclusionIncreased resistance was found for macrolides and tetracycline in patients with CAP by S. pneumoniae.

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Serotype Distribution and Drug Resistance inStreptococcus pneumoniae, Palestinian Territories

Cited by 8 publications

References 11 publications

Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution and Antimicrobial Resistance

Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution and Antimicrobial Resistance

Current Trend in Pneumococcal Serotype Distribution in Asia

The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumoniae

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