Microbiological and therapeutical aspects of pneumococcal diseases in the Slovak Republic

Area of Science:

• Microbiology
• Clinical Medicine
• Public Health

Background:

• Multiresistant *Streptococcus pneumoniae* strains, primarily serotypes 14, 23F, and 19A, have been documented in Slovakia since 1983.
• A 15-year collaborative effort highlights the persistent public health importance of pneumococcal infections in the Slovak Republic.

Purpose of the Study:

• To analyze the microbiological and clinical characteristics of acute otitis media in children under 5 years old.
• To assess the prevalence and antimicrobial resistance patterns of *Streptococcus pneumoniae* in pediatric otitis media and invasive infections.

Main Methods:

• Prospective, multicentric microbiological and clinical analysis.
• Isolation and susceptibility testing of pneumococcal strains from pediatric otitis media cases.
• Review of studies on invasive pneumococcal infections across different age groups.

Main Results:

• *Streptococcus pneumoniae* was isolated in 45.9% of pediatric otitis media cases.
• 50.8% of isolated strains showed intermediate/full penicillin resistance, and 47.5% were macrolid-resistant.
• Penicillin resistance was higher in children under 5 (52.8%) compared to other age groups. Serotypes 14, 19A, and 6A were dominant in childhood, while serotype 14 was most frequent in sterile fluids and otitis media samples.

Conclusions:

• Pneumococcal infections, particularly those caused by resistant strains like serotype 14, remain a critical issue in Slovakia.
• High antimicrobial resistance rates in pediatric otitis media necessitate ongoing surveillance and potential therapeutic strategy adjustments.