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

Authors Habibi Ghahfarokhi S, Mosadegh M, Ahmadi A, Pourmand MR, Azarsa M, Rahbar M, Nikmanesh B

Received 13 October 2019

Accepted for publication 23 January 2020

Published 4 February 2020 Volume 2020:13 Pages 333—340

DOI https://doi.org/10.2147/IDR.S234295

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Joachim Wink


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

1Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Department of Microbiology, Khoy University of Medical Sciences, Khoy, Iran; 4Department of Microbiology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran; 5Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran

Correspondence: Mohammad Reza Pourmand
Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Poursina St., Keshavarz Blvd., Tehran 1417613151, Iran
Tel/Fax +98 21-88-95-4910
Email mpourmand@tums.ac.ir

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: Streptococcus pneumoniae, serotype, pneumococcal conjugate vaccine, PCV, antibiotic susceptibility, multi-drug resistance, MDR


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