Serotype distribution of disease-causing Streptococcus pneumoniae in Thailand: A systematic review

This study aimed to explore the prevalence, antimicrobial resistance levels, and serotype distribution of S. pneumoniae in the Middle East region. We conducted a systematic literature review by searching several databases including PubMed, ISI Web of Science, Scopus, Google scholar through 2000 to 2017 by using the following keywords: “Streptococcus pneumoniae”, “pneumococcus”, “serotype”, “Antibiotic resistance,” and “Middle East “in combination with “OR” and “AND” Boolean Operators within Title/Abstract/Keywords fields. We used a random-effects model to calculate the pooled prevalence and 95% confidence intervals (CIs) for binomial variables. All statistical analyses were done using STATA 12.0 (STATA Corp, College Station, TX). We found 73 articles appropriate, on the word of inclusion and exclusion criteria, for inclusion in this systematic review and meta-analysis. The result revealed that the pooled prevalence of S. pneumoniae carriage was 35% (95% CI: 26-44%). The most frequent pneumococcal serotypes were19, 19F, 6, 23 and 6A/B which were found in 19%,12%, 11%, 10% and 10% of isolates respectively. Pneumococcal resistance reported for azithromycin, cefaclor, clarithromycin, chloramphenicol, erythromycin, and tetracycline were 24%, 37%, 23%, 11%, 26%, and 29% respectively, while vancomycin resistance was not reported. The highest resistant prevalence was reported against co-trimoxazole (Trimethoprim/sulfamethoxazole). For this antibiotic, a pooled resistance prevalence of 43% was identified. The present review demonstrates that the prevalence of S. pneumoniae carriage was high in the Middle East region. Surveillance must be continued in this region to evaluate. The resistance pattern and serotype distribution.

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A systematic review and meta-analysis of serotype distribution of Streptococcus pneumoniae in Iran: Practical evidences to optimizing local vaccination protocols

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666191002142953 ◽

2020 ◽

Vol 20 ◽

Author(s):

Abdollah Karimi ◽

Seyedeh Mahsan Hoseini-Alfatemi ◽

Sedigheh Rafiei Tabatabaei

Keyword(s):

Systematic Review ◽

Streptococcus Pneumoniae ◽

Web Of Science ◽

Data Extraction ◽

Meta Analysis ◽

Healthy Individuals ◽

Inclusion Criteria ◽

Serotype Distribution ◽

Invasive Diseases ◽

Iranian Patients

Background: Little is known regarding the burden of predominant circulating serotypes of Streptococcus pneumoniae in Iran. Therefore, this study aimed to investigate the serotype distribution of pneumococcal diseases in Iran by using a comprehensive systematic review of available articles. Methods: A systematic literature search carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, Embase and Google Scholar electronic databases since January of 2000 to December of 2018. Then, eight publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive MetaAnalysis software. Results: Totally, three studies reported the distribution of S. pneumoniae serotypes among patients, two studies among healthy individuals, and three studies among both groups. Of those studies, serotype 19A/F (17.9%; 95% CI: 13.6-23.0) was the most circulating serotype followed by 23A/F (12.3%; 95% CI: 7.7-19.2), 6A/B (11.0%; 95% CI: 8.0-14.9), and 14 (8.8%; 95% CI: 5.8-13.2). In contrast, the lowest circulating serotype was 60 (0.02%; 95% CI: 0.0-1.2), 29 (0.07%; 95% CI: 0.01-5.0), and 36 (0.09%; 95% CI: 0.04-2.1). Meta-regression results showed that prevalence of serotype 23A/F significantly increased each year about 0.2% (95% CI: 0.1- 0.3, P <0.001, tau2 <0.001). Conclusion: In the present study, it was found that over the last decade, the most prevalent serotypes in Iran were 19, 23, 6, and 14, respectively. These findings provides practical evidences to select effective pneumococcal vaccine candidates in the prevention of invasive diseases in Iranian patients, and also comparing our situation with others.

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