Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae in the Philippines, 2004-2011
Keywords:
Streptococcus pneumoniae, antimicrobial resistance, serotype, ARSPAbstract
Objective. Scarcity of data on the serotype composition and antibiotic resistance of invasive pneumococci from developing countries has been noted. We describe in this study the serogroup distribution and antimicrobial resistance patterns of Streptococcus pneumoniae in the Philippines from 2004-2011.
Methodology. S. pneumoniae isolated from patients with invasive pneumococcal disease were referred to the Antimicrobial Resistance Surveillance Reference Laboratory from 2004 to 2011. Typing of isolates was done through slide agglutination and antimicrobial susceptibility was determined following CLSI methods.
Results. The penicillin-resistant meningitis isolates were of serotypes 1, 5 and 14 which are covered by PCV10 and 13. The erythromycin resistant isolates were serotype 9 while cotrimoxazole resistant isolates were serotypes 1, 5, 6, 12 and 14. Forty-one percent of the cotrimoxazole resistant isolates are covered by PCV7, and 88% are covered by both PCV10 and PCV13. Levofloxacin resistant isolates were of serotypes 5 and 23 with PCV7 coverage of 50% and PCV10 and PCV13 coverages of 100%.
Conclusion. S. pneumoniae serotypes causing IPD in the country is largely similar to the dominant IPD serotypes worldwide. The serotype distribution in the Philippines remained stable from 2004 to 2011 and antimicrobial resistance among the isolates remained low. The serotypes of antibiotic resistant S. pneumoniae in this study were not similar with known serotype resistance profiles in other Asian countries. With the inclusion of PCV in the national free national immunization program of the country beginning 2013, continued surveillance of prevailing pneumococcal serotypes should be done to monitor any shift in the prevalence of PCV associated serotypes to guide disease control measures including control of emergence of resistant pneumococcal isolates.
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References
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35. Molander V, Elisson C, Balaji V, Backhaus E, John J, Vargheese R, et al. Invasive pneumococcal infections in Vellore, India: clinical characteristics and distribution of serotypes. BMC Infect Dis. 2013;13:532. PMID: 24206667. PMCID: PMC3827497. https://doi.org/10.1186/1471-2334-13-532.
2. Chong CY, Koh-Cheng T, Yee-Hui M, Nancy TW. Invasive pneumococcal disease in Singapore children. Vaccine. 2008;26(27-28):3427-31. PMID: 18499309. https://doi.org/10.1016/j.vaccine.2008.04.035.
3. Bravo LC. Asian Strategic Alliance for Pneumococcal Disease Prevention (ASAP) Working Group. Overview of the disease burden of invasive pneumococcal disease in Asia. Vaccine. 2009;27(52):7282-91. PMID: 1933708. https://doi.org/10.1016/j.vaccine.2009.04.046.
4. Lynch JP 3rd, Zhanel GG. Streptococcus pneumoniae: Epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines. Curr Opin Pulm Med. 2010;16(3):217-25. PMID: 20375783. https://doi.org/ 10.1097/MCP.0b013e3283385653.
5. World Health Organization. World Health Assembly 63, No. A63/26. Treatment and prevention of pneumoniae: Report by the Secretariat,2010. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_26-en.pdf.
6. Kattan R, Rayyan AA, Zheiman I, Idkeidek S, Baraghithi S, Rishmawi N, et al. Serotype distribution and drug resistance in Streptococcus pneumoniae, Palestinian territories. Emerg Infect Dis. 2011; 17(1): 94–6. PMCID: PMC3204635. https://doi.org/10.3201/eid1701.100886.
7. Buxbaum A, Forsthuber S, Graninger W, Georgopoulos A, Austrian Bacterial Surveillance Network. Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in Austria. J Antimicrob Chemother. 2004;54(1):247-50. PMID: 15140858. https://doi.org/10.1093/jac/dkh250.
8. World Health Organization. index to immunization, vaccines and biologicals. research and development. Available from: http://www.who.int/immunization/research/en/.
9. Jacobs MR, Good CE, Bajaksouzian S, Windau AR. Emergence of Streptococcus pneumoniae serotypes 19A, 6C, and 22F and serogroup 15 in Cleveland, Ohio, in relation to introduction of the protein-conjugated pneumococcal vaccine. Clin Infect Dis. 2008;47(11):1388-95. https://doi.org/ 10.1086/592972.
10. Calatayud L, Ardanuy C, Tubau F, Rolo D, Grau I, Pallarés R, et al. Serotype and genotype replacement among macrolide-resistant invasive Pneumococci in adults: Mechanisms of resistance and association with different transposons. J Clin Microbiol. 2010;48(4):1310-6. PMID: 20147647. PMCID: PMC2849543. https://doi.org/10.1128/JCM.01868-09.
11. Philippine Foundation for Vaccination. Childhood immunization schedule 2005. Available from: http://www.philvaccine.org/vaccination-schedules/childhood-immunization-schedule.
12. Philippine Foundation for Vaccination childhood immunization schedule 2006. Available from: http://www.philvaccine.org/vaccination-schedules/childhood-immunization-schedule.
13. Saha SK, Baqui AH, Darmstadt GL, Ruhulamin M, Hanif M, El Arifeen S, et al. Comparison of antibiotic resistance and serotype composition of carriage and invasive pneumococci among Bangladeshi children: Implications for treatment policy and vaccine formulation. J Clin Microbiol. 2003;41(12): 5582-7. PMID: 14662944. PMCID: PMC308982.
14. Phongsamart W, Srifeungfung S, Dejsirilert S, Chatsuwan T, Nunthapisud P, Treerauthaweeraphong V, et al. Serotype distribution and antimicrobial susceptibility of S. pneumoniae causing invasive disease in Thai children younger than 5 years old, 2000-2005. Vaccine. 2007;25(7):1275-80. PMID: 17092618. https://doi.org/10.1016/j.vaccine.2006.10.001.
15. Fenoll A, Jado I, Vicioso D, Pérez A, Casal J. Evolution of Streptococcus pneumoniae serotypes and antibiotic resistance in Spain: Update (1990 to 1996). J Clin Microbiol. 1998;36(12):3447-54. PMID: 9817852. PMCID: PMC105219.
16. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2006, p.143.
17. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2007, p. 187.
18. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2008, p. 209.
19. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2009, p. 233.
20. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Twenty-first informational supplement. CLSI document M100S21. Wayne (PA): Clinical and Laboratory Standards Institute, 2015.
21. Shutt CK, Samore M, Carroll KC. Comparison of Denka Seiken Slide Agglutination Method to the Quellung Test for Serogrouping of Streptococcus pneumoniae Isolates. J Clin Microbiol. 2004;42(3):1274-6. PMCID: PMC356897. https://doi.org/ 10.1128/JCM.42.3.1274-1276.2003.
22. Denka Seiken Co., Ltd. Bacterial Typing Antisera Handbook, 2006, p.41.
23. Capeding MRZ, Sombrero LT, Esparar GA, Mondoy MU, Taclibon AG. Pneumococcal serotypes among filipino children admitted in a tertiary care center for infectious diseases from 2000 to 2005. Pediatr Infect Dis Soc Philipp J. 2009;10(1):2-4.
24. Lucero MG, Nohynek H, Williams G, Tallo V, Simões EA, Lupisan S, et al. Efficacy of an 11-valent pneumococcal conjugate vaccine against radiologically confirmed pneumonia among children less than 2 years of age in the Philippines: a randomized, double-blind, placebo-controlled trial. Pediatr Infect Dis J. 2009;28(6):455-62. PMID: 19483514. https://doi.org/ 10.1097/INF.0b013e31819637af.
25. Capeding MRZ, Sombrero LT, Lucero MG, Saniel MC. Serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Filipino children. J Infect Dis. 1994;169(2):479-80.
26. Philippine Foundation for Vaccination. Schedule for adult immunization 2015. Available from: http://www.philvaccine.org/vaccination-schedules/adult-immunization-schedule.
27. Shen CF, Wang SM, Lee KH, Ho TS, Liu CC. Childhood invasive pneumococcal disease caused by non-7-valent pneumococcal vaccine (PCV7) serotypes under partial immunization in Taiwan. J Formos Med Assoc. 2013 ;112(9):561-8. PMID: 23916313. https://doi.org/10.1016/j.jfma.2013.05.015.
28. Tsai HY, Chen YH, Liao CH, Lu PL, Huang CH, Lu CT, et al. Trends in the antimicrobial susceptibilities and serotypes of Streptococcus pneumoniae: results from the Tigecycline in vitro surveillance in Taiwan (TIST) study, 2006-2010. Int J Antimicrob Agents. 2013;42(4):312-6. PMID: 23849332. https://doi.org/10.1016/j.ijantimicag.2013.05.013.
29. Huang SS, Platt R, Rifas-Shiman SL, Pelton SI, Goldmann D, Finkelstein JA. Post-PCV7 changes in colonizing pneumococcal serotypes in 16 Massachusetts communities, 2001 and 2004. Pediatrics. 2005;116(3):e408-13. PMID: 16140686. https://doi.org/10.1542/peds.2004-2338.
30. Feikin DR, Kagucia EW, Loo JD, Link-Gelles R, Puhan MA, Cherian T, et al. Serotypespecific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites. PLoS Med. 2013;10(9):e1001517. PMID: 24086113. PMCID: PMC3782411. https://doi.org/10.1371/journal.pmed.1001517.
31. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2010, p. 251.
32. Antimicrobial Resistance Surveillance Program. Antimicrobial Resistance Surveillance Program Progress Reports January – December 2011, p. 267.
33. Song JH, Jung SI, Ko KS, Kim NY, Son JS, Chang HH, et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother. 2004;48(6):2101-7. PMID: 15155207. PMCID: PMC415617. https://doi.org/10.1128/AAC.48.6.2101-2107.2004.
34. Schrag SJ, Beall B, Dowell S. Resistant pneumococcal infections: The burden of disease and challenges in monitoring and controlling antimicrobial resistance. Switzerland: World Health Organization,2001. Available from: http://www.who.int/drugresistance/technicalguidance/en/resistantinfection.pdf.
35. Molander V, Elisson C, Balaji V, Backhaus E, John J, Vargheese R, et al. Invasive pneumococcal infections in Vellore, India: clinical characteristics and distribution of serotypes. BMC Infect Dis. 2013;13:532. PMID: 24206667. PMCID: PMC3827497. https://doi.org/10.1186/1471-2334-13-532.
Published
04/09/2017
How to Cite
Sia, S., Carlos, C., Hufano, M. C., Lagrada, M., Ealdama, J., Sepulveda, M. T., & Masim, M. (2017). Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae in the Philippines, 2004-2011. PJP, 2(1), 23. Retrieved from https://philippinejournalofpathology.org/index.php/PJP/article/view/56
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