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Mokaddas E, Asadzadeh M, Syed S, Albert MJ. High Prevalence of Novel Sequence Types in Streptococcus pneumoniae That Caused Invasive Diseases in Kuwait in 2018. Microorganisms 2024; 12:225. [PMID: 38276209 PMCID: PMC10819824 DOI: 10.3390/microorganisms12010225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Multilocus sequence typing (MLST) is used to gain insight into the population genetics of bacteria in the form of sequence type (ST). MLST has been used to study the evolution and spread of virulent clones of Streptococcus pneumoniae in many parts of the world. Such data for S. pneumoniae are lacking for the countries of the Arabian Peninsula, including Kuwait. METHODS We determined the STs of all 31 strains of S. pneumoniae from invasive diseases received at a reference laboratory from various health centers in Kuwait during 2018 by MLST. The relationship among the isolates was determined by phylogenetic analysis. We also determined the serotypes by Quellung reaction, and antimicrobial susceptibility by Etest, against 15 antibiotics belonging to 10 classes. RESULTS There were 28 STs among the 31 isolates, of which 14 were new STs (45.2%) and 5 were rare STs (16.1%). Phylogenetic analysis revealed that 26 isolates (83.9%) were unrelated singletons, and the Kuwaiti isolates were related to those from neighboring countries whose information was gleaned from unpublished data available at the PubMLST website. Many of our isolates were resistant to penicillin, erythromycin, and azithromycin, and some were multidrug-resistant. Virulent serotype 8-ST53, and serotype 19A with new STs, were detected. CONCLUSIONS Our study detected an unusually large number of novel STs, which may indicate that Kuwait provides a milieu for the evolution of novel STs. Novel STs may arise due to recombination and can result in capsular switching. This can impact the effect of vaccination programs on the burden of invasive pneumococcal disease. This first report from the Arabian Peninsula justifies the continuous monitoring of S. pneumoniae STs for the possible evolution of new virulent clones and capsular switching.
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Affiliation(s)
| | | | | | - M. John Albert
- Department of Microbiology, College of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; (E.M.); (M.A.); (S.S.)
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Ktari S, Ben Ayed N, Ben Rbeh I, Garbi N, Maalej S, Mnif B, Rhimi F, Hammami A. Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018. BMC Microbiol 2023; 23:36. [PMID: 36739390 PMCID: PMC9898894 DOI: 10.1186/s12866-023-02784-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/25/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide. In this study, we sought to analyze serotype distributions, antibiotic resistance, and genetic relationships of 106 clinical invasive pneumococcal isolates recovered in Tunisia between 2012 and 2018, prior to the routine use of pneumococcal conjugate vaccines (PCV). METHODS We used multiplex PCR, the disk diffusion method and/or E-test, and multi-locus sequence typing (MLST). RESULTS The most frequent serotypes were 14 (17%), 19F (14.2%), and 3 (11.3%). Of the 106 S. pneumoniae isolates, 67.9% were penicillin non-susceptible (29.4% were resistant), 45.3% were amoxicillin non-susceptible (17% were resistant), and 16% were cefotaxime non-susceptible. For antibiotics other than β-lactams, resistance rates to erythromycin, tetracycline, cotrimoxazole, and chloramphenicol were 62.3, 33, 22.6, and 4.7%, respectively. Two isolates were non-susceptible to levofloxacin. Among 66 erythromycin-resistant pneumococci, 77.3% exhibited the cMLSB phenotype, and 87.9% carried ermB gene. All tetracycline-resistant strains harbored the tetM gene. The potential coverage by 7-, 10-, and 13-valent pneumococcal conjugate vaccines were 55.7, 57.5, and 81.1%, respectively. A multilocus sequence typing analysis revealed great diversity. Fifty different sequence types (STs) were identified. These STs were assigned to 10 clonal complexes and 32 singletons. The most common STs were 179, 2918, 386, and 3772 - related mainly to 19F, 14, 6B/C, and 19A serotypes, respectively. CONCLUSIONS This study demonstrated that the majority of the serotypes of invasive pneumococci in the Tunisian population were 14, 19F, and 3. Moreover, we noted a high degree of genetic diversity among invasive S. pneumoniae isolates. The highest proportions of antibiotic non-susceptible isolates were for penicillin, erythromycin, and tetracycline. Further molecular characteristics are required to monitor the genetic variations and to follow the emergence of resistant pneumococci for the post-vaccination era in Tunisia.
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Affiliation(s)
- Sonia Ktari
- Laboratory of Microbiology, Faculty of Medicine Sfax, University of Sfax-Tunisia, Avenue Majida Boulila, 3027, Sfax, Tunisia. .,Research Laboratory Microorganisms and Human Disease "MPH LR03SP03", Sfax, Tunisia.
| | - Nourelhouda Ben Ayed
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Imen Ben Rbeh
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia
| | - Nourhène Garbi
- Medical Genetic Department, HediChaker Hospital, Sfax, Tunisia
| | - Sonda Maalej
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Basma Mnif
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Faouzia Rhimi
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Adnene Hammami
- grid.412124.00000 0001 2323 5644Laboratory of Microbiology, Faculty of Medicine Sfax, University of Sfax-Tunisia, Avenue Majida Boulila, 3027 Sfax, Tunisia ,Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
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