Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution andAntimicrobial Resistance
Date
2013-12-10
Authors
Nasereddin, Abedelmajeed
Shtayeh, Issa
Ramlawi, Asad
Salman, Nisreen
Salem, Ibrahim
Journal Title
Journal ISSN
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Publisher
Public Library of Science
Abstract
Infections of Streptococcus pneumoniae in children can be prevented by vaccination; left untreated, they cause high
morbidity and fatalities. This study aimed at determining the nasopharyngeal carrier rates, serotype distribution and
antimicrobial resistance patterns of S. pneumoniae in healthy Palestinian children under age two prior to the full
introduction of the pneumococcal 7-valent conjugate vaccine (PCV7), which was originally introduced into Palestine in a
pilot trial in September, 2010. In a cross sectional study, nasopharyngeal specimens were collected from 397 healthy
children from different Palestinian districts between the beginning of November 2012 to the end of January 2013. Samples
were inoculated into blood agar and suspected colonies were examined by amplifying the pneumococcal-specific autolysin
gene using a real-time PCR. Serotypes were identified by a PCR that incorporated different sets of specific primers.
Antimicrobial susceptibility was measured by disk diffusion and MIC methods. The resulting carrier rate of Streptococcus
pneumoniae was 55.7% (221/397). The main serotypes were PCV7 serotypes 19F (12.2%), 23F (9.0%), 6B (8.6%) and 14 (4%)
and PCV13 serotypes 6A (13.6%) and 19A (4.1%). Notably, serotype 6A, not included in the pilot trial (PCV7) vaccine, was the
most prevalent. Resistance to more than two drugs was observed for bacteria from 34.1% of the children (72/211) while
22.3% (47/211) carried bacteria were susceptible to all tested antibiotics. All the isolates were sensitive to cefotaxime and
vancomycin. Any or all of these might impinge on the type and efficacy of the pneumococcal conjugate vaccines and
antibiotics to be used for prevention and treatment of pneumococcal disease in the country.
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Citation
Nasereddin A, Shtayeh I, Ramlawi A, Salman N, Salem I, et al. (2013) Streptococcus pneumoniae from Palestinian Nasopharyngeal Carriers: Serotype Distribution and Antimicrobial Resistance. PLoS ONE 8(12): e82047. doi:10.1371/journal.pone.0082047