title: Serotypes and genotypes of Streptococcus pneumoniae isolates from Trinidad and Tobago.
abstract: OBJECTIVE
  There are currently 94 known pneumococcal capsular polysaccharide serotypes and their prevalence differs by geographic region and the period studied. Streptococcus pneumoniae infections have been diagnosed clinically in Trinidad and Tobago and other Caribbean countries, however data on the serotype and sequence type distributions in this country are limited. The objective of this study was to determine serotypes and multilocus sequence types (MLSTs) of invasive and non-invasive pneumococcal isolates from Trinidad and Tobago.
  
  
  METHODS
  Ninety-eight pneumococcal isolates from several regional hospitals in the country were analyzed using both standard microbiological methods and molecular analysis. These isolates included invasive (n=83) and selected non-invasive (n=15) strains recovered before (n=25) and after (n=73) the introduction of the pneumococcal conjugate vaccine.
  
  
  RESULTS
  More than half of the isolates (54.1%) were recovered from children under 15 years of age, with the largest proportion being from children under 2 years of age (24.5%). The most prevalent serotypes were 19F (18.4%), 6B (15.3%), 23F (14.3%), 3 (11.2%), 19A (6.1%), 6A (5.1%), 14 (5.1%), and 9V (4.1%). The most common serotype/MLST combinations were 6B/ST138 (n=10, 10.2%), 3/ST180 (n=5, 5.1%), 23F/ST629 (n=5, 5.1%), 19F/ST8398 (n=4, 4.1%), and three each of 6B/ST145, 14/9V/ST156, 9V/ST162, 19A/320, and 3/ST10440.
  
  
  CONCLUSIONS
  This report provides the first glimpse of the prevailing pneumococcal sequence types in the country. Most of the isolates represented serotypes in the 10-valent (61.2% of isolates) and 13-valent (83.7%) pneumococcal conjugate vaccines. A detailed population study is warranted to fully determine the circulating pneumococcal sequence types. Furthermore, the implementation of an effective and continuous surveillance system in Trinidad and Tobago is paramount to monitor vaccine impact.
authors.affiliation: Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago.
authors.forename: Michele
authors.initials: M
authors.lastname: Nurse-Lucas
authors.affiliation: Respiratory Disease Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
authors.forename: Lesley
authors.initials: L
authors.lastname: McGee
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Paulina A
authors.initials: PA
authors.lastname: Hawkins
authors.affiliation: Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago.
authors.forename: William H
authors.initials: WH
authors.lastname: Swanston
authors.affiliation: Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago. Electronic address: peakpaka@yahoo.co.uk.
authors.forename: Patrick Eberechi
authors.initials: PE
authors.lastname: Akpaka
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D058885:Multilocus Sequence Typing; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology; D015995:Prevalence; D013296:Streptococcus pneumoniae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D014300:Trinidad and Tobago / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000276:immunology
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Invasive pneumococcal disease; Multilocus sequence typing; Pneumococcal conjugate vaccine; Sequence type; Trinidad and Tobago