Ten-year surveillance of invasive Streptococcus pneumoniae isolates in central Turkey prior to the introduction of a conjugate vaccine.

INTRODUCTION: The aim of this study was to characterize the serotypes and antimicrobial susceptibility patterns of invasive Streptococcus pneumoniae isolates in central Turkey.
METHODOLOGY: A total of 332 invasive S. pneumoniae isolates were identified, serotyped and tested for antimicrobial susceptibility by routine microbiological methods.
RESULTS: The most common serogroups/serotypes were 1, 19, 3, 18, 6, 14, and 7 in rank order. Serogroup/serotype coverage of the 23-valent polysaccharide vaccine, and the 7-, 10-, and 13-valent conjugate vaccines were 96%, 44%, 78.6%, 96.4%, respectively. Overall, 20 (6%) of the isolates were resistant to penicillin, 1 (0.3%) to cefotaxime, 20 (6%) to erythromycin, 13 (4%) to cloramphenicol, and 120 (36%) to trimethoprim-sulfamethoxasole. Among cerebrospinal fluid (CSF) isolates, 20 (18.5%) were resistant to penicillin (26.3% and 11.5%, respectively, of child and adult meningitis cases; p ≥ 0.05).
CONCLUSIONS: Although the seven-valent conjugate vaccine is expected to protect less than half of children younger than three years of age, of the incorporation of this vaccine into the routine immunization program of Turkey is advised to continue. However, the 13-valent conjugate vaccine, including serotypes 1, 3, 5, and 7, has the most potential prevent the highest burden of invasive pneumococcal diseases in this age group.