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Mamishi S, Pourakbari B, Bahador A, Sadeghi RH, Pourhajibagher M. Monitoring Over a Decade in the Serotype Prevalence of Streptococcus pneumoniae in Iran: A Systematic Review and Meta-analysis. Infect Disord Drug Targets 2024; 24:e031123223116. [PMID: 37937572 DOI: 10.2174/0118715265265907231025111012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND There is no comprehensive information about the circulating serotypes of Streptococcus pneumoniae in Iran in recent years. This study aimed to summarize information about the changes over a decade in the serotype prevalence of S. pneumoniae in Iran. METHODS We performed a comprehensive search in PubMed/Medline, Web of Science, Science Direct, and the Iranian Database, such as Magiran and SID, from January 2011 to February 2023. The systematic process, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), was carried out by two researchers who were both independent and calibrated. Statistical analyses were carried out using Comprehensive Meta-Analysis software. Identifying and measuring heterogeneity were done using I2 and the chi-square test. Finally, Begg's rank correlation test was used in combination with a funnel plot to evaluate any possible publication bias. RESULTS The search returned 16 relevant results, with a total of 1575 isolates. Of those studies, eight studies reported the distribution of S. pneumoniae serotypes among patients, three studies among healthy individuals, and five studies among both groups. As the meta-analysis revealed, the most common serotypes were 23F (n = 299, 14.1% [95% CI: 9.7-19.9]; I2 = 84.3%; P<0.001 for heterogeneity), 19F (n = 221, 13.4% [95% CI: 9.9-17.9; I2 = 76.7%; P<0.001 for heterogeneity]), and 19A (n = 102, 8.7% [95% CI: 6.5-11.7; I2 = 54.3%; P<0.001 for heterogeneity]). Moreover, Begg's test (P = 0.160, 0.173, and 0.176 for 23F, 19F, and 19A, respectively) showed no evidence of publication bias. CONCLUSION Based on our pooled results, the majority of the serotypes of pneumococci in the Iranian population were 23F, 19F, and 19A, respectively, over the last decade. The findings can be valuable in selecting effective pneumococcal vaccine candidates and targeted antibiotics in Iranian patients.
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Affiliation(s)
- Setareh Mamishi
- Pediatric Infectious Diseases Research Center, Children's Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Diseases Research Center, Children's Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Fellowship in Clinical Laboratory Sciences, BioHealth Lab, Tehran, Iran
| | - Reihaneh Hosseinpour Sadeghi
- Pediatric Infectious Diseases Research Center, Children's Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Dawood HN, Al-Jumaili AH, Radhi AH, Ikram D, Al-Jabban A. Emerging pneumococcal serotypes in Iraq: scope for improved vaccine development. F1000Res 2023; 12:435. [PMID: 38283903 PMCID: PMC10811421 DOI: 10.12688/f1000research.132781.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 01/30/2024] Open
Abstract
Pneumococcal disease is a global public health concern as it affects the young, aged and the immunocompromised. The development of pneumococcal vaccines and their incorporation in the immunization programs has helped to reduce the global burden of disease. However, serotype replacement and the emergence of non-vaccine serotypes as well as the persistence of a few vaccine serotypes underscores the need for development of new and effective vaccines against such pneumococcal serotypes. In the Middle East, places of religious mass gatherings are a hotspot for disease transmission in addition to the global risk factors. Therefore, the periodic surveillance of pneumococcal serotypes circulating in the region to determine the effectiveness of existing prevention strategies and develop improved vaccines is warranted. Currently, there is a lack of serotype prevalence data for Iraq due to inadequate surveillance in the region. Thus, this review aims to determine the pneumococcal serotypes circulating in Iraq which may help in the development and introduction of improved pneumococcal vaccines in the country.
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Affiliation(s)
| | | | - Ahmed H. Radhi
- F.i.c.m.s/ C.M, Center for disease control and prevention, Baghdad, Iraq
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Williams AN, Ma A, Croxen MA, Demczuk WHB, Martin I, Tyrrell GJ. Genomic analysis of Streptococcus pneumoniae serogroup 20 isolates in Alberta, Canada from 1993-2019. Microb Genom 2023; 9. [PMID: 38015202 DOI: 10.1099/mgen.0.001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
In the province of Alberta, Canada, invasive disease caused by Streptococcus pneumoniae serogroup 20 (serotypes 20A/20B) has been increasing in incidence. Here, we characterize provincial invasive serogroup 20 isolates collected from 1993 to 2019 alongside invasive and non-invasive serogroup 20 isolates from the Global Pneumococcal Sequencing (GPS) Project collected from 1998 to 2015. Trends in clinical metadata and geographic location were evaluated, and serogroup 20 isolate genomes were subjected to molecular sequence typing, virulence and antimicrobial resistance factor mining, phylogenetic analysis and pangenome calculation. Two hundred and seventy-four serogroup 20 isolates from Alberta were sequenced, and analysed along with 95 GPS Project genomes. The majority of invasive Alberta serogroup 20 isolates were identified after 2007 in primarily middle-aged adults and typed predominantly as ST235, a sequence type that was rare among GPS Project isolates. Most Alberta isolates carried a full-length whaF capsular gene, suggestive of serotype 20B. All Alberta and GPS Project genomes carried molecular resistance determinants implicated in fluoroquinolone and macrolide resistance, with a few Alberta isolates exhibiting phenotypic resistance to azithromycin, clindamycin, erythromycin, tetracycline and trimethoprim-sulfamethoxazole, as well as non-susceptibility to tigecycline. All isolates carried multiple virulence factors including those involved in adherence, immune modulation and nutrient uptake, as well as exotoxins and exoenzymes. Phylogenetically, Alberta serogroup 20 isolates clustered with predominantly invasive GPS Project isolates from the USA, Israel, Brazil and Nepal. Overall, this study highlights the increasing incidence of invasive S. pneumoniae serogroup 20 disease in Alberta, Canada, and provides insights into the genetic and clinical characteristics of these isolates within a global context.
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Affiliation(s)
- Ashley N Williams
- Department of Laboratory Medicine and Pathology, University of Alberta, 5-411 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9 Canada
- Alberta Precision Laboratory - Public Health Laboratory, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7 Canada
| | - Angela Ma
- Department of Laboratory Medicine and Pathology, University of Alberta, 5-411 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9 Canada
- Department of Pathology, University of Utah School of Medicine, 15 North Medical Drive East, Ste. #1100, Salt Lake City, UT, 84112 USA
| | - Matthew A Croxen
- Department of Laboratory Medicine and Pathology, University of Alberta, 5-411 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9 Canada
- Alberta Precision Laboratory - Public Health Laboratory, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7 Canada
- Li Ka Shing Institute of Virology, University of Alberta, 6-010 Katz Centre for Health Research, 11315 - 87 Ave NW, Edmonton, Alberta, T6G 2E1 Canada
- Women & Children's Health Research Institute (WCHRI), University of Alberta, 5-083 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue NW Edmonton, AB, T6G 1C9 Canada
| | - Walter H B Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, R3E 3R2 Canada
| | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, R3E 3R2 Canada
| | - Gregory J Tyrrell
- Department of Laboratory Medicine and Pathology, University of Alberta, 5-411 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9 Canada
- Alberta Precision Laboratory - Public Health Laboratory, 8440 112 Street NW, Edmonton, Alberta, T6G 2B7 Canada
- Li Ka Shing Institute of Virology, University of Alberta, 6-010 Katz Centre for Health Research, 11315 - 87 Ave NW, Edmonton, Alberta, T6G 2E1 Canada
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Leal JT, Primon-Barros M, de Carvalho Robaina A, Pizzutti K, Mott MP, Trentin DS, Dias CAG. Streptococcus pneumoniae serotype 19A from carriers and invasive disease: virulence gene profile and pathogenicity in a Galleria mellonella model. Eur J Clin Microbiol Infect Dis 2023; 42:399-411. [PMID: 36790530 DOI: 10.1007/s10096-023-04560-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE This study aimed to evaluate and compare the presence of genes related to surface proteins between isolates of Streptococcus pneumoniae from healthy carriers (HC) and invasive pneumococcal disease (IPD) with a particular focus on serotype 19A. METHODS The presence of these genes was identified by real-time PCR. Subsequently, we employed the Galleria mellonella larval infection model to study their effect on pathogenicity in vivo. RESULTS The percentage of selected virulence genes was similar between the HC and IPD groups (p > 0.05), and the genes lytA, nanB, pavA, pcpA, phtA, phtB, phtE, rrgA, and sipA were all present in both groups. However, the virulence profile of the isolates differed individually between HC and IPD groups. The highest lethality in G. mellonella was for IPD isolates (p < 0.01), even when the virulence profile was the same as compared to the HC isolates or when the nanA, pspA, pspA-fam1, and pspC genes were not present. CONCLUSIONS The occurrence of the investigated virulence genes was similar between HC and IPD S. pneumoniae serotype 19A groups. However, the IPD isolates showed a higher lethality in the alternative G. mellonella model than the HC isolates, regardless of the virulence gene composition, indicating that other virulence factors may play a decisive role in virulence. Currently, this is the first report using the in vivo G. mellonella model to study the virulence of clinical isolates of S. pneumoniae.
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Affiliation(s)
- Josiane Trevisol Leal
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
- Laboratório de Bacteriologia & Modelos Experimentais Alternativos, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Biociências (PPGBIO), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Muriel Primon-Barros
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
| | - Amanda de Carvalho Robaina
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
| | - Kauana Pizzutti
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
| | - Mariana Preussler Mott
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
| | - Danielle Silva Trentin
- Laboratório de Bacteriologia & Modelos Experimentais Alternativos, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Biociências (PPGBIO), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil.
| | - Cícero Armídio Gomes Dias
- Laboratório de Microbiologia Molecular, Departamento de Ciências Básicas da Saúde, Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande Do Sul, Brasil
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Determination of Streptococcus pneumonia Serotypes Isolated from Clinical Specimens: A Step Toward the Production of a Native Vaccine in Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid.112897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Streptococcus pneumoniae remains a major cause of invasive streptococcal diseases among all age groups, particularly infants and the elderly. Objectives: This study aimed to recognize and determine S. pneumoniae serotypes isolated from clinical specimens by multiplex polymerase chain reaction (PCR). Methods: A total of 105 pneumococcal strains were collected from nonvaccinated cases within the age range of 10 days to 92 years from five provinces of Iran within June 2017 to August 2019. The strains were cultured on blood agar. Biochemical analyses and molecular tests were performed for the primary identification of bacterial isolates. Capsular typing was carried out by multiplex PCR assay. Primers that target the capsular polysaccharide site were used in this study. Results: Out of 130 studied clinical specimens, 105 isolates of S. pneumoniae were detected and identified. The most frequently isolated capsular types were 6B, 14, 19A, and 1. Serotype distribution consisted of 83.5% of vaccine serotype and 16.5% of nonvaccine serotype. The serotype 6B was significantly more frequent (P < 0.05) among the invasive clinical isolates (75%) compared to that among their noninvasive counterparts (25%). The distribution of 13-valent pneumococcal conjugate vaccine (PCV-13) serotypes in invasive pneumococcal disease (IPD) and non-IPD revealed 83% and 84% of the isolated serotypes, respectively. Moreover, 83.5% of all the serotypes identified in the study were covered by PCV-13 serotypes. Conclusions: The common serotypes of invasive and noninvasive groups in Iran are covered by PCV-13.
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Serotype Distribution of Streptococcus pneumoniae Carriage in Six-Month-Old Infants: A Cross-sectional Study During 2017-18, Tehran, Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2021. [DOI: 10.5812/pedinfect.112705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Streptococcus pneumoniae is recognized as one of the main pathogens inducing several invasive and non-invasive infections in children. Objective: The present study aimed to evaluate the serotype distribution of S. pneumoniae in six–month–old carriers. Methods: This study encompassed 600 six-month-old healthy infants whose pharyngeal swap samples were collected and then cultured to isolate S. pneumoniae. Twenty- five different serotypes were defined on positive culture samples by multiplex PCR. Results: In this study, 13 cases (2.2%) were positive S. pneumonia. The most common isolated serotypes of S. pneumoniae were serotypes 23F (n = 6, 1%) and 3 (n = 3, 0.5%), respectively. Notably, the most frequent serotype in formula-fed infants (n = 300) was Serotype 23F (n = 5, 1.7%); however, Serotype 3 (n = 3, 1%) was the most frequent one in breastfed participants (n = 300). According to the findings, the overall coverage of PCV10, PCV13, and PPSV23 on the S. pneumoniae serotypes at the age of six months was 50%, 73%, and 85%, respectively. Conclusions: At this age, the type of feeding could not significantly affect the frequency rate of S. pneumoniae colonization, while the serotype distributions in the two breastfed and formula-fed groups were different.
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