[Serotype distribution and antibiotic resistance of Streptococcus pneumoniae strains isolated from the adult patients in a Turkish üniversity hospital]. 2017

Lütfiye Öksüz, and Nezahat Gürler
Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey. loksuz34@yahoo.com.

Infections caused by Streptococcus pneumoniae are the most important cause of morbidity and mortality worldwide. S.pneumoniae is the most common cause of community-acquired pneumonia, especially in adults. Invasive pneumococcal disease can usually occur in the elderly, children and immunocompromised individuals. Usage of the vaccines for the protection against S.pneumoniae infections, is an effective method to reduce the burden of disease in both children and adults. Serotypes frequently isolated from purified capsular polysaccharides of S.pneumoniae are used in polyvalent vaccines. Significant differences are observed between countries and regions in serotypes and antibiotic resistance of S.pneumoniae strains. For this reason, each country and region should determine their own serotypes and antibiotic resistance. The aim of this study was to determine serotype distribution, antibiotic resistance and vaccine coverage rates in S.pneumoniae strains isolated from invasive and non-invasive samples of adult patients in our hospital. A total of 100 S.pneumoniae isolates from invasive and non-invasive samples of adult patients between March 2007 and August 2014 were used in this study. S.pneumoniae strains were identified by conventional methods. Serogrouping was performed with the latex particle agglutination and serotyping was made with the conventional Quellung reaction using a commercial type-spesific antisera (Statens Serum Institute, Copenhagen, Denmark). Antibiotic susceptibility testing for penicillin G, cefotaxime and erythromycin was performed by gradient test and evaluated according to the breakpoints of Clinical and Laboratory Standards Institute (CLSI). Sixty four percent of of the S.pneumoniae strains were isolated from non-invasive and 36% were isolated from invasive samples. Serotype 3 (20%), 19F (9%), 8 (7%), 14 (7%), 23F (6%), 6A (6%) were most common determined serotypes among all strains. Among S.pneumoniae strains isolated from invasive samples serotype 3 (22%), 14 (14%), 1 (8%) and in S.pneumoniae strains isolated from non-invasive samples 3 (19%), 19F (11%), 6A (9%), 23F (8%) were the most common serotypes. Among all isolates 2% penicillin and 3% cefotaxime intermediate resistance were detected. Erythromycin resistance was detected in 25% of invasive, 37% of non-invasive strains and a total of 33% in all of the isolates. Vaccine coverage rates were found to be 68% for PCV13 and 78% for PPV23 among all isolates. In our study penicillin resistance was lower compared with the other similar studies in the world, but resistance against erythromycin was almost similar. This study is important to show that serotype 3 predominated in serious pneumococcal infections in the adult population of our hospital. For this reason, administration of routine pneumococcal vaccination program in adults and especially in the elderly is recommended. In conclusion, it is important to know the serotype distribution and antibiotic resistance of S.pneumoniae to monitor the empirical treatment in serious pneumococcal infections.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010400 Penicillin G A penicillin derivative commonly used in the form of its sodium or potassium salts in the treatment of a variety of infections. It is effective against most gram-positive bacteria and against gram-negative cocci. It has also been used as an experimental convulsant because of its actions on GAMMA-AMINOBUTYRIC ACID mediated synaptic transmission. Benzylpenicillin,Benpen,Benzylpenicillin Potassium,Coliriocilina,Crystapen,Or-pen,Parcillin,Pekamin,Pengesod,Penibiot,Penicilina G Llorente,Penicillin G Jenapharm,Penicillin G Potassium,Penicillin G Sodium,Penicillin Grünenthal,Penilevel,Peniroger,Pfizerpen,Sodiopen,Sodipen,Sodium Benzylpenicillin,Sodium Penicillin,Unicilina,Ursopen,Van-Pen-G
D011008 Pneumococcal Infections Infections with bacteria of the species STREPTOCOCCUS PNEUMONIAE. Streptococcus pneumoniae Infections,Infections, Pneumococcal,Infections, Streptococcus pneumoniae,Pneumococcal Diseases,Disease, Pneumococcal,Diseases, Pneumococcal,Infection, Pneumococcal,Infection, Streptococcus pneumoniae,Pneumococcal Disease,Pneumococcal Infection,Streptococcus pneumoniae Infection
D002439 Cefotaxime Semisynthetic broad-spectrum cephalosporin. Benaxima,Biosint,Cefotaxim,Cefotaxime Sodium,Cefradil,Cephotaxim,Claforan,Fotexina,HR-756,Kendrick,Klaforan,Primafen,Ru-24756,Taporin,HR 756,HR756,Ru 24756,Ru24756,Sodium, Cefotaxime
D004917 Erythromycin A bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. Erycette,Erymax,Erythromycin A,Erythromycin C,Erythromycin Lactate,Erythromycin Phosphate,Ilotycin,T-Stat,Lactate, Erythromycin,Phosphate, Erythromycin,T Stat,TStat
D006785 Hospitals, University Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research. University Hospitals
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old

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