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. 2020 Feb 4:13:333-340.
doi: 10.2147/IDR.S234295. eCollection 2020.

Serotype Distribution and Antibiotic Susceptibility of Streptococcus pneumoniae Isolates in Tehran, Iran: A Surveillance Study

Soheila Habibi Ghahfarokhi  1 , Mehrdad Mosadegh  1 , Ali Ahmadi  2 , Mohammad Reza Pourmand  1 , Mohammad Azarsa  3 , Mohammad Rahbar  4 , Bahram Nikmanesh  5
Affiliations

Serotype Distribution and Antibiotic Susceptibility of Streptococcus pneumoniae Isolates in Tehran, Iran: A Surveillance Study

Soheila Habibi Ghahfarokhi et al. Infect Drug Resist. .

Abstract

Introduction: Encapsulated Streptococcus pneumoniae strains cause high morbidity and mortality, mainly in countries with no pneumococcal conjugate vaccines (PCVs) immunization program. This study investigated the epidemiological changes of S. pneumoniae isolates including serotype distribution and antimicrobial susceptibility in Tehran, Iran.

Methods: A total of 80 S. pneumoniae samples were collected from patients admitted to Shariati hospital over two periods. Half of the isolates were collected from February to September 2017 and the other half from July 2018 to March 2019. The antimicrobial susceptibility testing and PCV-13 serotype coverage of S. pneumoniae isolates were evaluated among patients with invasive and non-invasive infections.

Results: The most common serotypes were 23F (17.5%), 14 (16.3%), 3 (16.3%) 19F (12.5%), and 19A (12.5%) in the present study. The vaccine coverage rates of PCV-7, PCV-10 and PCV-13 were 52.6%, 52.6%, and 83.7%, respectively. S. pneumoniae isolates with the serotype of the PCV-13 showed an increasing trend during the study. Nearly half of the S. pneumoniae strains were MDR, while MDR serotype 19A increased (40%) during the study periods. A small minority of isolates (16%) belonged to non-vaccine serotypes, 65% of which were assigned to MDR. In general, the frequency of penicillin resistant and MDR strains were estimated about 27.5% and 51%, respectively. An increase was observed in resistance to erythromycin and co-trimoxazole.

Conclusion: The results showed that majority of the circulating serotypes in our study are related to PCV-13 serotypes. The use of conjugate vaccine in the immunization program and surveillance of antimicrobial resistance can be effective in reducing the pneumococcal clinical burden.

Keywords: MDR; PCV; Streptococcus pneumoniae; antibiotic susceptibility; multi-drug resistance; pneumococcal conjugate vaccine; serotype.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of S. pneumoniae serotypes isolated from IPD & non-IPD. Abbreviations: IPD, invasive pneumococcal disease; Non-IPD, non-invasive pneumococcal disease; NVT, non-vaccine type.
Figure 2
Figure 2
Antibiotic susceptibility of S. pneumoniae isolates.
Figure 3
Figure 3
Serotype distribution of S. pneumoniae isolates according to penicillin susceptibility.
Figure 4
Figure 4
Serotype distribution of MDR S. pneumoniae isolates. Abbreviations: IPD, invasive pneumococcal disease; Non-IPD, non-invasive pneumococcal disease.
See this image and copyright information in PMC

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