Antimicrobial Susceptibility Pattern and Serotype Distribution of Streptococcus Pneumoniae in the Middle East Region: A Systematic Review and Meta-Analysis
-
Samira Karimaei
,
Hamid Reza Tohidinik
,
Davoud Afshar
,
Mohammad Reza Pourmand
,
Soheila Habibi Ghahfarokhi
,
Narjes Noori Goodarzi
,
Mohammad Azarsa
Abstract
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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2. Al-Sherikh Y, K Gowda L, Ali M, Marie M, John J, Khaled Homoud Mohammed D, et al. distribution of serotypes and antibiotic susceptibility patterns among invasive pneumococcal diseases in Saudi Arabia. Ann Lab Med 2014;34:210-5.
3. Habibian S, Mehrabi-Tavana A, Ahmadi Z, Izadi M, Jonaidi N, Darakhshanpoure J, et al. Serotype distribution and antibiotics susceptibility pattern of Streptococcus pneumonia in Iran. Iran Red Crescent Med J 2013;15:e8053.
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5. Mahboobi R, Afshar D, Pourmand MR, and Mashhadi R. Autolytic activity and plasma binding study of Aap, a novel minor autolysin of Streptococcus pneumoniae. Acta Med Iran 2016;54:196-200.
6. Kadioglu A, Weiser JN, Paton JC, Andrew PW. The role of Streptococcus pneumoniae virulence factors in host respiratory colonization and disease. Nat Rev Microbiol 2008;6:288-301.
7. Institute JB. The Joanna Briggs Institute Reviewers’ Manual 2014 edition. Adelaide: JBI, 2014.
8. Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health 2014;72:39.
9. Ahmadi A, Talebi M, Irajian G. High Prevalence of Erythromycin-and Tetracycline-Resistant Clinical Isolates of Streptococcus pneumoniae in Iran. Infect Dis Clin Pract 2013;21:299-301.
10. Ahmed K, Martinez G, Wilson S, Yoshida R, Dhar R, Mokaddas E, et al. The prevalence and clonal diversity of penicillin-resistant Streptococcus pneumoniae in Kuwait. Epidemiol Infect 2000;125:573-81.
11. Aliskan HE, Colakoglu S, Gocmen JS. Antibiotic resistance of streptococcus pneumoniae and haemophilus influenzae isolated from respiratory tract specimens. Cukurova Med J 2016;41:201-7.
12. Al-Mazrou A, Twum-Danso K, Al Zamil F. Streptococcus pneumoniae serotypes/serogroups causing invasive disease in Riyadh, Saudi Arabia: extent of coverage by pneumococcal vaccines. Ann Saudi Med 2005;25:94-9.
13. Alnimr AM, Farhat M. Phenotypic and molecular study of pneumococci causing respiratory tract infections A 3-year prospective cohort. Saudi Med J 2017;38:350-8.
14. Al-Swailem AM, Kadry AA, Fouda SI, Shibl AM, Shair OH. Phenotypic and genotypic characterization of invasive Streptococcus pneumoniae clinical isolates. Curr Ther Res Clin Exp 2004;65:423-32.
15. Al-Tawfiq JA. Pattern of antibiotic resistance of Streptococcus pneumoniae in a hospital in the Eastern Province of Saudi Arabia. J Chemother 2004;16:259-63.
16. Al-Tawfiq JA. Antibiotic resistance of pediatric isolates of Streptococcus pneumoniae in a Saudi Arabian hospital from 1999 to 2004. Med Sci Monit 2006;12:CR471-5.
17. Altinkanat Gelmez G, Soysal A, Kuzdan C, Karadag B, Hasdemir U, Bakir M, et al. [Serotype distribution and antibiotic susceptibilities of Streptococcus pneumoniae causing acute exacerbations and pneumonia in children with chronic respiratory diseases]. Mikrobiyol Bul 2013;47:684-92.
18. Altun B, Gur D, Kocagoz S, Hascelik G, Unal S. Molecular epidemiology of penicillin resistant Streptococcus pneumoniae strains in Turkey. A multicenter study. Ann Microbiol 2006;56:185-90.
19. Altun HU, Hascelik G, Gur D, Eser OK. Invasive pneumococci before the introduction of pneumococcal conjugate vaccine in Turkey: antimicrobial susceptibility, serotype distribution, and molecular identification of macrolide resistance. J Chemother 2015;27:74-9.
20. Ashtiani MTH, Sadeghian M, Nikmanesh B, Pourakbari B, Mahmoudi S, Mamishi S. Antimicrobial susceptibility trends among Streptococcus pneumoniae over an 11-year period in an Iranian referral children Hospital. Iran J Microbiol 2014;6:382-6.
21. Aslan G, Ernekdas G, Bayer M, Serin MS, Kuyucu N, Kanik A. Serotype distribution of Streptococcus pneumoniae strains in the nasopharynx of healthy Turkish children. Indian J Med Res 2007;125:582-7.
22. Aslan G, Tezcan S, Delialioglu N, Aydin FE, Kuyucu N, Emekdas G. [Evaluation of penicillin-binding protein genotypes in penicillin susceptible and resistant Streptococcus pneumoniae isolates]. Mikrobiyol Bul 2012;46:190-201.
23. Ataee RA, Habibian S, Mehrabi-Tavana A, Ahmadi Z, Jonaidi N, Salesi M. Determination of vancomycin minimum inhibitory concentration for ceftazidime resistant Streptococcus pneumoniae in Iran. Ann Clin Microbiol Antimicrob 2014;13:53.
24. Bahy RH, Hamouda HM, Shahat AS, Yassin AS, Amin MA. Emergence of Neoteric Serotypes Among Multidrug Resistant Strains of Streptococcus pneumoniae Prevalent in Egypt. Jundishapur J Microbiol 2016;9:e30708.
25. Bayer M, Aslan G, Emekdas G, Kuyucu N, Kanik A. [Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children and multidrug resistance]. Mikrobiyol Bul 2008;42:223-30.
26. Bayraktar MR, Durmaz B, Kalcioglu MT, Durmaz R, Cizmeci Z, Aktas E. Nasopharyngeal carriage, antimicrobial susceptibility, serotype distribution and clonal relatedness of Streptococcus pneumoniae isolates in healthy children in Malatya, Turkey. Int J Antimicrob Agents 2005;26:241-6.
27. Bokaeian M, Khazaei HA, Javadimehr M. Nasopharyngeal Carriage, Antibiotic Resistance and Serotype Distribution of Streptococcus Pneumoniae among Healthy Adolescents in Zahedan. Iran Red Crescent Med J 2011;13:328-33.
28. Bokaeian M, Khazaei HA, Javadimehr M. Serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates from children in Zahedan, Iran. African J Microbiol Res 2012;6:28-33.
29. Ceyhan M, Ozsurekci Y, Gurler N, Ozkan S, Sensoy G, Belet N, et al. Distribution of Streptococcus pneumoniae Serotypes That Cause Parapneumonic Empyema in Turkey. Clin Vaccine Immunol 2013;20:972-6.
30. Ciftci E, Dogru U, Aysev D, Ince E, Guriz H. Nasopharyngeal colonization with penicillin-resistant Streptococcus pneumoniae in Turkish children. Pediatr Int 2000;42:552-6.
31. Dabboussi F, Allouche S, Mallat H, Hamze M. Prevalence of first-step mutants among levofloxacin-susceptible isolates of Streptococcus pneumoniae in north Lebanon. J Chemother 2013;25:328-31.
32. Daoud Z, Cocozaki A, Hakime N. Antimicrobial susceptibility patterns of Haemophilus influenzae and Streptococcus pneumoniae isolates in a Beirut general university hospital between 2000 and 2004. Clin Microbiol Infect 2006;12:86-90.
33. Daoud Z, Kourani M, Saab R, Nader MA, Hajjar M. Resistance of Streptococcus pneumoniae isolated from Lebanese patients between 2005 and 2009. Rev Esp Quimioter 2011;24:84-90.
34. Dashti AS, Abdinia B, Karimi A. Nasopharyngeal carrier rate of Streptococcus pneumoniae in children: serotype distribution and antimicrobial resistance. Arch Iran Med 2012;15:500-3.
35. Elshafie S, Taj-Aldeen SJ. Emerging resistant serotypes of invasive Streptococcus pneumoniae. Infect Drug Resist 2016;9:153-60.
36. Eltahawy AT. Antimicrobial resistance of Streptococcus pneumoniae at a university hospital in Saudi Arabia. J Chemother 2001;13:148-53.
37. Esel D, Sumerkan B, Kocagoz S. Epidemiology of penicillin resistance in Streptococcus pneumoniae isolates in Kayseri, Turkey. Clin Microbiol Infect 2001;7:548-52.
38. Fouda S, Kadry A, Shibl A. β-lactam and macrolide resistance and serotype distribution among Streptococcus pneumoniae isolates from Saudi Arabia. J Chemother 2004;16:517-23.
39. Gonullu N, Berkiten R. Antimicrobial resistance of clinical isolates of Streptococcus pneumoniae in Istanbul. Int J Antimicrob Agents 2000;16:77-8.
40. Gonullu N, Catal F, Kucukbasmaci O, Ozdemir S, Torun MM, Berkiten R. Comparison of in vitro activities of tigecycline with other antimicrobial agents against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in two university hospitals in Istanbul, Turkey. Chemotherapy 2009;55:161-7.
41. Guldemir D, Acar S, Otgun SN, Unaldi O, Gozalan A, Ertek M, et al. High-Level Genetic Diversity among Invasive Streptococcus pneumoniae Isolates in Turkey. Japanese Journal of Infectious Diseases. 2016;69:207-12.
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| Files | ||
| Issue | Vol 59, No 2 (2021) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/acta.v59i2.5572 | |
| Keywords | ||
| Streptococcus pneumoniae Antimicrobial susceptibility Serotype Middle east | ||
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How to Cite
1.
Karimaei S, Tohidinik HR, Afshar D, Pourmand MR, Habibi Ghahfarokhi S, Noori Goodarzi N, Azarsa M. Antimicrobial Susceptibility Pattern and Serotype Distribution of Streptococcus Pneumoniae in the Middle East Region: A Systematic Review and Meta-Analysis. Acta Med Iran. 2021;59(2):64-78.
