engleski

Invasive pneumococcal disease caused by non-PCV isolates in children < 18 years of age in Croatia, 2005 to 2016

Background Streptococcus pneumoniae is a leading cause of bacterial pneumonia, meningitis, and sepsis in children worldwide. The aim of this study was to assess serotype distribution and antibiotic resistance in non-PCV pneumococci causing invasive infections in children <18 years of age in Croatia in a twelve year period during which only risk groups were vaccinated. Methods Invasive pneumococcal strains were collected through the microbiological laboratory network with country coverage of >95%. Capsular typing was performed by the Quellung reaction (Statens Serum Institut, Copenhagen). Strains nontypeable by the Quellung reaction were submitted to PCR typing (CDC protocol). In vitro susceptibility testing was performed by disc diffusion method according to EUCAST guidelines. In strains with reduced susceptibility to penicillin (as detected by oxacillin screen disk), MIC for penicillin was determined (E-test, Biomerieux, France). Results Among a total of 451 invasive pneumococci 69 isolates (15%) were non-PCV serotypes while 48 isolates (11%) were not covered with any vaccine. The most prevalent non-PCV serotypes belonged to serotype 11A (5 isolates), 15B (4 isolates) and non-vaccine groups 25 (25F, 25A), 38, 43, 44, 45, 46, 48 (5 isolates) and 16 (16F, 16A), 36, 37 (4 isolates). 3% (16 isolates) of all isolates remain nontypeable by methods used. Non- susceptibility to penicillin was 17%, only one isolate was highly resistant. Resistance to macrolides was also 17%. Conclusions Non-PCV serotypes were detected in 15 % of all invasive pneumococcal disease in children. Non-PCV isolates were most frequently isolated in children 12– <60 months. Non- susceptibility to penicillin and resistance to macrolides were lower than 20 % and were not serotype specific.

invasive pneumococcal disease ; antimicrobial resistance ; serotype distribution ; vaccine coverage

nije evidentirano