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Serotypes and resistance patterns of Streptococcus pneumoniae causing systemic disease in northern Norway
1Department of Medical Microbiology, University Hospital, Tromsø, Norway.
Abstract:
During the period 1985-1990, Streptococcus pneumoniae was isolated form 97 patients with systemic pneumococcal disease in Northern Norway. Systemic disease occurred most frequently in the age groups 0-4 years and > 60 years. An increasing incidence was observed, especially among children less than five years old. Serotypes covered by the 23-valent pneumococcal polysaccharide vaccine were found in 86 of 97 (88.7%) isolates. The vaccine did not cover 16.7% of the systemic isolates from children less than five years old. Reduced sensitivity to penicillin was found in one isolate (1.0%) which was resistant to ampicillin, doxycycline and chloramphenicol. The E-test and the Rosco agar diffusion test differed in sensitivity to penicillin, chloramphenicol, ciprofloxacin and erythromycin. Three serotype 12F strains showed unusual cross-resistance to chloramphenicol and erythromycin.
Insights
Streptococcus pneumoniae caused systemic disease in Northern Norway, particularly in young children and the elderly. The 23-valent pneumococcal vaccine covered most strains, but not all in children under five.
Area of Science:
- Microbiology
- Epidemiology
- Immunology
Background:
- Streptococcus pneumoniae is a leading cause of bacterial pneumonia, meningitis, and sepsis.
- Pneumococcal disease incidence and serotype distribution vary geographically and over time.
- Vaccination with the 23-valent pneumococcal polysaccharide vaccine (23-valent PPSV) is a key preventive strategy.
Purpose of the Study:
- To analyze the epidemiology of systemic pneumococcal disease in Northern Norway from 1985-1990.
- To evaluate the coverage of the 23-valent PPSV against circulating Streptococcus pneumoniae serotypes.
- To assess antimicrobial resistance patterns and compare antibiotic susceptibility testing methods.
Main Methods:
- Retrospective analysis of Streptococcus pneumoniae isolates from 97 patients with systemic disease.
- Serotyping of isolates to determine coverage by the 23-valent PPSV.
- Antimicrobial susceptibility testing using E-test and Rosco agar diffusion methods.
Main Results:
- Systemic pneumococcal disease predominantly affected children aged 0-4 years and adults over 60 years.
- An increasing incidence was noted, especially in children under five.
- The 23-valent PPSV covered 88.7% of isolates; however, 16.7% of isolates from children under five were not covered.
- Reduced penicillin sensitivity was observed in one isolate (1.0%), which also showed resistance to other antibiotics.
- Discrepancies in antimicrobial sensitivity testing were noted between E-test and Rosco agar diffusion methods.
- Three serotype 12F strains exhibited cross-resistance to chloramphenicol and erythromycin.
Conclusions:
- Systemic pneumococcal disease remains a significant public health concern, particularly in vulnerable age groups.
- While the 23-valent PPSV offers broad protection, gaps in coverage exist for certain serotypes in young children.
- Monitoring antimicrobial resistance and evaluating diagnostic methods are crucial for effective disease management.