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Updated: Jul 6, 2026

Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43
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Antibiotic non-susceptibility associated serotypes of invasive pneumococcal disease - a nationwide population study

Nicolaj Just1, Carlo Casanova2,3, Florent Baty4

  • 1Division of Infectious Diseases, Infection Prevention and Travel Medicine, HOCH Health Ostschweiz, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Pneumonia (Nathan Qld.)
|July 4, 2026
PubMed

Insights

Antibiotic resistance in invasive pneumococcal disease (IPD) decreased from 2012-2022, unaffected by the COVID-19 pandemic. Specific vaccine and non-vaccine serotypes remain linked to antibiotic resistance, highlighting the need for ongoing surveillance.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Vaccinology

Background:

  • The thirteen-valent pneumococcal conjugate vaccine (PCV13) introduction may impact antibiotic resistance in invasive pneumococcal disease (IPD).
  • Current data on antibiotic resistance trends in IPD are limited.
  • The study investigates the influence of PCV13 and the COVID-19 pandemic on IPD antibiotic resistance and mortality.

Purpose of the Study:

  • To analyze the impact of PCV13 introduction and the COVID-19 pandemic on antibiotic resistance in IPD.
  • To examine the association between antibiotic resistance and mortality in IPD cases.
  • To correlate specific vaccine and non-vaccine serotypes with antibiotic resistance patterns.

Main Methods:

  • Utilized a Swiss nationwide IPD surveillance database covering 8747 cases from 2012-2022.
  • Employed regression analyses to identify temporal trends and factors associated with antibiotic resistance.
  • Correlated serotypes and patient characteristics with antibiotic resistance and mortality outcomes.

Main Results:

  • Non-susceptibility to erythromycin and cotrimoxazole decreased significantly from 2012-2022.
  • Penicillin non-susceptibility remained stable, with a notable decrease in 2022.
  • Specific PCV13 serotypes (6B, 9V, 14, 19A, 19F) and non-PCV13 serotypes (15A, 23B, 24/F, 6C) showed significant associations with antibiotic resistance.
  • Antibiotic non-susceptibility was not linked to increased mortality, but meningitis cases showed an association with penicillin non-susceptibility.

Conclusions:

  • Antibiotic resistance in IPD has decreased over the study period, with no increase observed during the COVID-19 pandemic.
  • A persistent strong association exists between pneumococcal serotypes and antibiotic resistance profiles.
  • Continued surveillance and potential introduction of vaccines with broader serotype coverage are crucial for managing antibiotic resistance in IPD.
Abstract

Keywords:
Streptococcus pneumoniaeAntibiotic resistancePenicillin non-susceptibilityPneumococcal conjugate vaccines (PCVs)

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