title: Serotypes and Antibiotic Susceptibility of Streptococcus pneumoniae Isolates from Invasive Pneumococcal Disease and Asymptomatic Carriage in a Pre-vaccination Period, in Algeria.
abstract: In Algeria, few data is available concerning the distribution of pneumococcal serotypes and respective antibiotic resistance for the current pre-vaccination period, which is a public health concern. We identified the most frequent Streptococcus pneumoniae serogroup/types implicated in invasive pneumococcal disease (IPD; n = 80) and carriage (n = 138) in Algerian children younger than 5 years old. Serogroup/types of 78 IPD isolates were identified by capsular typing using a sequential multiplex PCR. Overall, serotypes 14, 19F, 6B, 23F, 18C, 1, 5, 7F, 19A, and 3 (55% of PCV7 serotypes, 71.3% of PCV10, and 90% of PCV13) were identified. Additionally, 7.5% of the non-vaccine serotypes 6C, 9N/L, 20, 24F, 35B, and 35F, were observed. In the case of S. pneumoniae asymptomatic children carriers, the most common serogroup/types were 6B, 14, 19F, 23F, 4, 9V/A, 1, 19A, 6A, and 3 (42.7% of PCV7 serotypes, 44.2% of PCV10, and 58% of PCV13). For 6.1% of the cases co-colonization was detected. Serotypes 14, 1, 5, and 19A were more implicated in IPD (p < 0.01), whereas serotype 6A was exclusively isolated from carriers (p < 0.01). Deaths associated with IPD were related to serotypes 19A, 14, 18C, and one non-typeable isolate. Among IPD related to vaccine serotypes, the rates of penicillin non-susceptible isolates were higher in no meningitis cases (80%) than in meningitis (66.7%), with serotypes 14, 19A, 19F, and 23F presenting the highest MIC levels (>2μg/ml). Resistance to cefotaxime was higher in isolates from meningitis (40.5%); however, resistance to erythromycin and co-trimoxazole (>40%) was more pronounced in no-meningeal forms. Overall, our results showed that PCV13 conjugate vaccine would cover up to 90% of the circulating isolates associated with IPD in Algeria, highlighting the importance of monitoring the frequency of S. pneumoniae serogroups/types during pre- and post-vaccination periods.
authors.affiliation: Service de Microbiologie Médicale, Centre Hospitalo-Universitaire Mustapha Bacha, Faculté de Médecine Algiers, Algeria.
authors.forename: Hanifa
authors.initials: H
authors.lastname: Ziane
authors.affiliation: National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo JorgeLisbon, Portugal; Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, University of OportoOporto, Portugal.
authors.forename: Vera
authors.initials: V
authors.lastname: Manageiro
authors.affiliation: National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge Lisbon, Portugal.
authors.forename: Eugénia
authors.initials: E
authors.lastname: Ferreira
authors.affiliation: National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge Lisbon, Portugal.
authors.forename: Inês B
authors.initials: IB
authors.lastname: Moura
authors.affiliation: Service de Microbiologie Médicale, Centre Hospitalo-Universitaire Mustapha Bacha, Faculté de Médecine Algiers, Algeria.
authors.forename: Soumia
authors.initials: S
authors.lastname: Bektache
authors.affiliation: Service de Microbiologie Médicale, Centre Hospitalo-Universitaire Mustapha Bacha, Faculté de Médecine Algiers, Algeria.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Tazir
authors.affiliation: National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge Lisbon, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Caniça
keywords: Algeria; antibiotic susceptibility; children; invasive disease; pneumococcal carriage; pneumococci serotype; vaccine