engleski

Serotype distribution, antimicrobial resistance and vaccine coverage of invasive pneumococcal isolates in children <18 years of age in Croatia, 2005 to 2019

Background Streptococcus pneumoniae is a major human pathogen causing invasive infections with high morbidity and mortality rate worldwide. The aim of this study was to assess serotype distribution, antibiotic resistance and vaccine coverage in pneumococci causing invasive infections in children <18 years of age in Croatia from 2005 to 2019. Methods Invasive pneumococcal strains were collected through the microbiological laboratory network organised by the Croatian Committee for Antimicrobial Resistance Surveillance. Capsular typing was performed by the Quellung reaction (Statens Serum Institut, Copenhagen). In vitro susceptibility testing was performed by disc diffusion method according to CLSI and EUCAST guidelines. In strains with reduced susceptibility to penicillin MIC for penicillin was determined (E-test, Biomerieux, France). Results A total of 448 invasive pneumococcal isolates (419 from blood and 29 from CSF) were isolated in children < 18 years of age in the study period. The most prevalent serotypes were 14 (110 isolates), 19A (47 isolates), 6B (46 isolates), 23F (37 isolates) and 18C (34 isolates) comprising 61% of all isolates and dominantly isolated in children < 5 years of age. Penicillin susceptibility, increased exposure was 25% and mostly found in serotypes 14 and 19A. Resistance to penicillin was low (<1%). Macrolide susceptibility was tested in 70% of isolates. Resistance was 41% mostly due to serotypes 14 and 19A. Vaccine coverage with 10-valent and 13-valent vaccine was 67% and 82%, respectively. Conclusions Incidence of invasive pneumococcal infection is the highest in children < 5 years of age. Penicillin susceptibility, increased exposure and macrolide resistance were mostly associated with serotypes 14 and 19A. Serotype 14 is covered by both vaccines whereas serotype 19A is covered by 13-valent vaccine only.

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

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