Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected from unvaccinated children with pneumonia at a province in central Vietnam
-
Bui Anh Son
,
Tang Xuan Hai
,
Tran Van Cuong
,
Duong Dinh Chinh
,
Thi-Hong-Hanh Le
,
Nguyen Manh Dung
,
Vu Nhat Dinh
,
Do Ngoc Anh
Abstract
Background and Objectives: Identification of pnemococcal serotypes and antimicrobial resistance provides helpful information for the use of suitable vaccines and antibiotics; however, very limited data is available on these issues in Vietnam. The present study aimed to find the serotype distribution and drug resistance patterns of Streptococcus pneumoniae isolated from unvaccinated children less than 5 years of age with pneumonia at a province in centre Vietnam.
Materials and Methods: A total of 126 clinical pnemococcal strains isolated from unvaccinated children less than 5 years of age with pneumonia at the Nghe An province, Vietnam between Nov 2019 and Mar 2021. All strains were identified using conventional microbiological method, VITEK® 2 Compact system, specific PCR and sequencing. The serotypes and antimicrobial resistance patterns of pnemococcal strains were determined using the multiplex PCR assays and VITEK® 2 Compact system.
Results: The results showed that, eight different pneumococcal serotypes were identified. The most common serotypes were 19F (67.46%), followed by 23F (10.32%), 19A (9.52%), 6A/B (3.17%), 15A (2.38%), 9V (3.17%), 11A (1.59%) and 14 (0.80%), respectively. More than half of the pneumococcal strains were non-susceptible to penicillin. The resistance rate to ceftriaxone and cefotaxime were 41.3% and 50.8%. The percentage of pneumococci strains resistant to clarithromycin, azithromycin, erythromycin, cotrimoxazole, tetracyclin, and clindamycin were more than 93% of all strains. All pneumococcal serotypes were highly resistant to clarithromycin, azithromycin, erythromycin, cotrimoxazole, and clindamycin.
Conclusion: Our findings showed high antibiotic resistance rates of the strains causing pneumococcal pneumonia, mostly macrolide resistance, among unvaccinated children.
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22. Parry CM, Duong NM, Zhou J, Mai NTH, Diep TS, Thinh LQ, et al. Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. Antimicrob Agents Chemother 2002; 46: 3512-3517.
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25. Sakata H. Invasive pneumococcal diseases in children in Hokkaido, Japan from April 2000, to March 2015. J Infect Chemother 2016; 22: 24-26.
26. El-Kholy A, Badawy M, Gad M, Soliman M. Serotypes and antimicrobial susceptibility of nasopharyngeal isolates of Streptococcus pneumoniae from children less than 5 years old in Egypt. Infect Drug Resist 2020; 13: 3669-3677.
27. Medeiros MIC, Almeida SCG, Guerra MLLS, Da Silva P, Carneiro AMM, De Andrade D. Distribution of Streptococcus pneumoniae serotypes in the northeast macro-region of São Paulo state/Brazil after the introduction of conjugate vaccine. BMC Infect Dis 2017; 17: 590.
28. Diawara I, Zerouali K, Katfy K, Zaki B, Belabbes H, Najib J, et al. Invasive pneumococcal disease among children younger than 5 years of age before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco. Int J Infect Dis 2015; 40: 95-101.
29. Pan F, Han L, Huang W, Tang J, Xiao S, Wang C, et al. Serotype distribution, antimicrobial susceptibility, and molecular epidemiology of Streptococcus pneumoniae isolated from children in Shanghai, China. PLoS One 2015; 10(11): e0142892.
30. Yu Y-Y, Xie X-H, Ren L, Deng Y, Gao Y, Zhang Y, et al. Epidemiological characteristics of nasopharyngeal Streptococcus pneumoniae strains among children with pneumonia in Chongqing, China. Sci Rep 2019; 9: 3324.
31. Johnson HL, Deloria-Knoll M, Levine OS, Stoszek SK, Freimanis Hance L, Reithinger R, et al. Systematic evaluation of serotypes causing invasive Pneumococcal disease among children under five: the Pneumococcal global serotype project. PLoS Med 2010; 7(10): e1000348.
32. Ktari S, Jmal I, Mroua M, Maalej S, Ben Ayed NE, Mnif B, et al. Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae strains in the south of Tunisia: A five-year study (2012–2016) of pediatric and adult populations. Int J Infect Dis 2017; 65: 110-115.
33. McGee L, McDougal L, Zhou J, Spratt BG, Tenover FC, George R, et al. Nomenclature of major antimicrobial-resistant clones of Streptococcus pneumoniae defined by the pneumococcal molecular epidemiology network. J Clin Microbiol 2001; 39: 2565-2571.
34. Lonks JR, Garau J, Gomez L, Xercavins M, De Echagüen AO, Gareen IF, et al. Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae. Clin Infect Dis 2002; 35: 556-564.
35. Kim SH, Song J-H, Chung DR, Thamlikitkul V, Yang Y, Wang H, et al. Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrob Agents Chemother 2012; 56: 1418-1426.
2. Houri H, Tabatabaei SR, Saee Y, Fallah F, Rahbar M, Karimi A. Distribution of capsular types and drug resistance patterns of invasive pediatric Streptococcus pneumoniae isolates in Teheran, Iran. Int J Infect Dis 2017; 57: 21-26.
3. Liu C, Xiong X, Xu W, Sun J, Wang L, Li J. Serotypes and patterns of antibiotic resistance in strains causing invasive pneumococcal disease in children less than 5 years of age. PLoS One 2013; 8(1): e54254.
4. Van de Vooren K, Duranti S, Curto A, Garattini L. Cost effectiveness of the new Pneumococcal vaccines: A systematic review of European studies. Pharmacoeconomics 2014; 32: 29-45.
5. Shi W, Zhou K, Yuan L, Meng Q, Dong F, Gao W, et al. Serotype distribution, antibiotic resistance patterns and molecular characteristics of serogroup 6 Streptococcus pneumoniae isolates collected from Chinese children before the introduction of PCV13. J Glob Antimicrob Resist 2018; 14: 23-28.
6. Wahl B, O'Brien KL, Greenbaum A, Majumder A, Liu L, Chu Y, et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Glob Health 2018; 6(7): e744-e757.
7. International Vaccine Access Center. Johns Hopkins Bloomberg School of Public Health. VIEW-hub report: Global vaccine introduction and Implementation, March 2019.
8. Beheshti M, Jabalameli F, Feizabadi MM, Hahsemi FB, Beigverdi R, Emaneini M. Molecular characterization, antibiotic resistance pattern and capsular types of invasive Streptococcus pneumoniae isolated from clinical samples in Tehran, Iran. BMC Microbiol 2020; 20: 167.
9. Wang J, Liu F, Ao P, Li X, Zheng H, Wu D, et al. Detection of serotype distribution and drug resistance of Streptococcus Pneumoniae isolated from pediatric patients. Lab Med 2017; 48: 39-45.
10. Huang S, Liu X, Lao W, Zeng S, Liang H, Zhong R, et al. Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected at a Chinese hospital from 2011 to 2013. BMC Infect Dis 2015; 15: 312.
11. Habibi Ghahfarokhi S, Mosadegh M, Ahmadi A, Pourmand MR, Azarsa M, Rahbar M, et al. Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae isolates in Tehran, Iran: A surveillance study. Infect Drug Resist 2020; 13: 333-340.
12. Hausdorff WP, Feikin DR, Klugman KP. Epidemiological differences among pneumococcal serotypes. Lancet Infect Dis 2005; 5: 83-93.
13. Zhao C, Li Z, Zhang F, Zhang X, Ji P, Zeng J, et al. Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates from 17 Chinese cities from 2011 to 2016. BMC Infect Dis 2017; 17: 804.
14. Song JY, Nahm MH, Moseley MA. Clinical implications of pneumococcal serotypes: invasive disease potential, clinical presentations, and antibiotic resistance. J Korean Med Sci 2013; 28: 4-15.
15. Nuorti JP, Whitney CG. Prevention of pneumococcal disease among infants and children - use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine - recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010; 59: 1-18.
16. International Vaccine Access Center. Johns Hopkins Bloomberg School of Public Health. VIEW-hub Report: Global Vaccine Introduction and Implementation, March 2020.
17. Reinert RR. The antimicrobial resistance profile of Streptococcus pneumoniae. Clin Microbiol Infect 2009; 15 Suppl 3: 7-11.
18. Miller CS, Handley KM, Wrighton KC, Frischkorn KR, Thomas BC, Banfield JF. Short-read assembly of full-length 16S amplicons reveals bacterial diversity in subsurface sediments. PLoS One 2013; 8(2): e56018.
19. Tan TQ. Pediatric invasive pneumococcal disease in the United States in the era of pneumococcal conjugate vaccines. Clin Microbiol Rev 2012; 25: 409-419.
20. Vo TT, Phan T, Ngo HTM, Pham H, Ho T. Antibiotic susceptibility of invasive Streptococcus pneumoniae isolates in southern Vietnam. Int J Infect Dis 2020; 101: 53-54.
21. Parry CM, Diep TS, Wain J, Hoa NT, Gainsborough M, Nga D, et al. Nasal carriage in Vietnamese children of Streptococcus pneumoniae resistant to multiple antimicrobial agents. Antimicrob Agents Chemother 2000; 44: 484-488.
22. Parry CM, Duong NM, Zhou J, Mai NTH, Diep TS, Thinh LQ, et al. Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. Antimicrob Agents Chemother 2002; 46: 3512-3517.
23. Jauneikaite E, Jefferies JM, Hibberd ML, Clarke SC. Prevalence of Streptococcus pneumoniae serotypes causing invasive and non-invasive disease in South East Asia: A review. Vaccine 2012; 30: 3503-3514.
24. Wu CJ, Lai JF, Huang IW, Shiau YR, Wang HY, Lauderdale TL. Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae in pre- and post- PCV7/13 Eras, Taiwan, 2002–2018. Front Microbiol 2020; 11: 557404.
25. Sakata H. Invasive pneumococcal diseases in children in Hokkaido, Japan from April 2000, to March 2015. J Infect Chemother 2016; 22: 24-26.
26. El-Kholy A, Badawy M, Gad M, Soliman M. Serotypes and antimicrobial susceptibility of nasopharyngeal isolates of Streptococcus pneumoniae from children less than 5 years old in Egypt. Infect Drug Resist 2020; 13: 3669-3677.
27. Medeiros MIC, Almeida SCG, Guerra MLLS, Da Silva P, Carneiro AMM, De Andrade D. Distribution of Streptococcus pneumoniae serotypes in the northeast macro-region of São Paulo state/Brazil after the introduction of conjugate vaccine. BMC Infect Dis 2017; 17: 590.
28. Diawara I, Zerouali K, Katfy K, Zaki B, Belabbes H, Najib J, et al. Invasive pneumococcal disease among children younger than 5 years of age before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco. Int J Infect Dis 2015; 40: 95-101.
29. Pan F, Han L, Huang W, Tang J, Xiao S, Wang C, et al. Serotype distribution, antimicrobial susceptibility, and molecular epidemiology of Streptococcus pneumoniae isolated from children in Shanghai, China. PLoS One 2015; 10(11): e0142892.
30. Yu Y-Y, Xie X-H, Ren L, Deng Y, Gao Y, Zhang Y, et al. Epidemiological characteristics of nasopharyngeal Streptococcus pneumoniae strains among children with pneumonia in Chongqing, China. Sci Rep 2019; 9: 3324.
31. Johnson HL, Deloria-Knoll M, Levine OS, Stoszek SK, Freimanis Hance L, Reithinger R, et al. Systematic evaluation of serotypes causing invasive Pneumococcal disease among children under five: the Pneumococcal global serotype project. PLoS Med 2010; 7(10): e1000348.
32. Ktari S, Jmal I, Mroua M, Maalej S, Ben Ayed NE, Mnif B, et al. Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae strains in the south of Tunisia: A five-year study (2012–2016) of pediatric and adult populations. Int J Infect Dis 2017; 65: 110-115.
33. McGee L, McDougal L, Zhou J, Spratt BG, Tenover FC, George R, et al. Nomenclature of major antimicrobial-resistant clones of Streptococcus pneumoniae defined by the pneumococcal molecular epidemiology network. J Clin Microbiol 2001; 39: 2565-2571.
34. Lonks JR, Garau J, Gomez L, Xercavins M, De Echagüen AO, Gareen IF, et al. Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae. Clin Infect Dis 2002; 35: 556-564.
35. Kim SH, Song J-H, Chung DR, Thamlikitkul V, Yang Y, Wang H, et al. Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrob Agents Chemother 2012; 56: 1418-1426.
| Files | ||
| Issue | Vol 14 No 5 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v14i5.10958 | |
| Keywords | ||
| Streptococcus pneumoniae; Serotypes; Antibiotic resistance; Children; Pneumonia | ||
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How to Cite
1.
Son B, Hai T, Cuong T, Chinh D, Le T-H-H, Dung N, Dinh V, Anh D. Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected from unvaccinated children with pneumonia at a province in central Vietnam. Iran J Microbiol. 2022;14(5):653-661.
