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Croatian Medical Journal, Vol. 63 No. 2, 2022.

Original scientific paper

https://doi.org/10.3325/cmj.2022.63.15 6

Serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates among Croatian adults during a fifteenyear period (2005-2019)

Iva Butić orcid id orcid.org/0000-0002-5542-9192 ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
Marija Gužvinec orcid id orcid.org/0000-0002-5920-8223 ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
Marko Jelić ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
Irena Groš orcid id orcid.org/0000-0002-3932-5852 ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
Sandra Lucić orcid id orcid.org/0000-0002-2377-6560 ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
Mile Bošnjak orcid id orcid.org/0000-0002-7663-198X ; Faculty of Economics and Business, University of Zagreb, Zagreb, Croatia
Arjana Tambić Andrašević ; Department of Clinical Microbiology, University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia

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Abstract

Aim To assess serotype distribution, antibiotic resistance,
and vaccine coverage against Streptococcus pneumoniae
causing invasive infections in Croatian adults from 2005 to
2019.
Methods In this retrospective study, invasive pneumococ
-
cal strains were collected through a microbiological lab
-
oratory network with country coverage >95%. Capsular
typing was performed with the Quellung reaction. In vitro
susceptibility testing was carried out according to the Eu
-
ropean Committee on Antimicrobial Susceptibility Twating
guidelines. In macrolide-resistant isolates, the presence of
ermB and mefA genes was evaluated.
Results During the fifteen-year study period, 1123 inva
-
sive pneumococcal isolates were obtained. The most prev
-
alent serotypes were 3, 14, 19A, 9V, 7F, and 23F, comprising
60% of all invasive pneumococcal isolates. Serotype 3 was
the dominant serotype, with the highest prevalence in pa
-
tients ≥65 years of age. Penicillin susceptibility, increased
exposure was 18.6%, mostly associated with serotypes 14
and 19A. Resistance to penicillin was low (<1%). Macrolide
resistance was 23%, mostly associated with serotypes 14,
19A, and 19F. The coverage with 13-valent conjugate vac
-
cine (PCV13) and 23-valent polysaccharide vaccine (PPV23)
was 80.2% and 93.6%, respectively.
Conclusions The incidence of invasive pneumococcal
disease in adults is highest in patients ≥65 years of age.
Penicillin susceptibility, increased exposure and macrolide
resistance were mostly associated with serotypes 14 and
19A. PCV13 and PPV23 provide very high serotype cover
-
age. Future studies should evaluate the effects of the 10-
valent vaccine, introduced in the Croatian National Immu
-
nization Program in June 2019, on serotype distribution
and antibiotic resistance rates.

Keywords

Hrčak ID:

279011

URI

https://hrcak.srce.hr/279011

Publication date:

21.4.2022.

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