Serotype Patterns Research Articles

Assessment of the prevalence, serotype, and antibiotic resistance pattern of Salmonella enterica in integrated farming systems in the Maryland-DC area.

Implementation of organic/pasture farming practices has been increasing in the USA regardless of official certification. These practices have created an increasingly growing demand for marketing safe products which are produced through these systems. Products from these farming systems have been reported to be at greater risk of transmitting foodborne pathogens because of current trends in their practices. Salmonella enterica (SE) is a ubiquitous foodborne pathogen that remains a public health issue given its prevalence in various food products, but also in the environment and as part of the microbial flora of many domestic animals. Monitoring antibiotic resistance and identifying potential sources contamination are increasingly important given the growing trend of organic/pasture markets. This study aimed to quantify prevalence of SE at the pre- and post-harvest levels of various integrated farms and sites in Maryland-Washington D.C. area, as well as identify the most prevalent serovars and antibiotic resistance patterns. Samples from various elements within the farm environment were collected and screened for SE through culture and molecular techniques, which served to identify and serotype SE, using species and serovar-specific primers, while antibiotic resistance was evaluated using an antibiogram assay. Results showed a prevalence of 7.80% of SE pre-harvest and 1.91% post-harvest. These results also showed the main sources of contamination to be soil (2.17%), grass (1.28%), feces (1.42%) and unprocessed produce (1.48%). The most commonly identified serovar was Typhimurium (11.32%) at the pre-harvest level, while the only identified serovar from post-harvest samples was Montevideo (4.35%). With respect to antibiotic resistance, out of the 13 clinically relevant antibiotics tested, gentamycin and kanamycin were the most effective, demonstrating 78.93 and 76.40% of isolates, respectively, to be susceptible. However, ampicillin, amoxicillin and cephradine had the lowest number of susceptible isolates with them being 10.95, 12.36, and 9.83%, respectively. These results help inform farms striving to implement organic practices on how to produce safer products by recognizing areas that pose greater risks as potential sources of contamination, in addition to identifying serotypes of interest, while also showcasing the current state of antibiotic efficacy and how this can influence antibiotic resistance trends in the future.

Vibrio cholerae O1 associated with recent endemic cholera shows temporal changes in serotype, genotype, and drug-resistance patterns in Bangladesh

BackgroundDespite the advancement in our understanding of cholera and its etiological agent, Vibrio cholerae, the prevention and treatment of the disease are often hindered due to rapid changes in drug response pattern, serotype, and the major genomic islands namely, the CTX-prophage, and related genetic characteristics. In the present study, V. cholerae (n = 172) associated with endemic cholera in Dhaka during the years 2015–2021 were analyzed for major phenotypic and genetic characteristics, including drug resistance patterns.ResultsResults revealed that the V. cholerae strains belonged to serogroup O1 biotype El Tor carrying El Tor -specific genes rtxC, tcpA El Tor, and hlyA El Tor, but possessed classical-biotype cholera toxin. Serotypes of V. cholerae strains differed temporally in predominance with Inaba during 2015–2017, and again in 2020–2021, while Ogawa was the predominant serotype in 2018–2019. Also, ctxB1 was predominant in V. cholerae associated with cholera during 2015–2017, while ctxB7 was predominant in 2018, and in the subsequent years, as observed until 2021. V. cholerae strains differed in their antibiotic resistance pattern with a majority (97%) being multi-drug resistant (MDR) and belonging to six sub-groups. Notably, one of these MDR strains was resistant to eleven of the eighteen antibiotics tested, with resistance to fourth-generation cephalosporin (cefepime), and aztreonam. This extreme drug resistant (XDR) strain carried resistance-related genes namely, extended-spectrum β-lactamases (ESBL), blaOXA-1 and blaPER-3.ConclusionThe observed temporal switching of serotypes, as well as the ctxB genotype, and the emergence of MDR/XDR V. cholerae and their association with endemic cholera in Dhaka underscore the need for routine monitoring of the pathogen for proper patient management.

Is There a Shift in Salmonella Diversity Among Poultry in Northern India?

The present study was conducted to determine the serotype diversity of Salmonella among poultry in northern India. A total of 101 poultry droppings from 30 farms in the Jammu and Kashmir union territory were analyzed. Nineteen isolates of Salmonella were obtained, and these belonged to four serotypes: Salmonella enterica enterica serotype Kentucky (n = 3), Salmonella enterica enterica serotype Infantis (n = 5), Salmonella enterica enterica serotype Agona (n = 4), and Salmonella enterica enterica serotype Typhimurium (n= 7). The study has isolated some Salmonella serotypes that are infrequently reported in India. Some of the isolated serotypes are reported to be endemic for human nontyphoidal salmonellosis cases in the region. Whether this indicates a shift in the serotype pattern in poultry in the region needs to be investigated further. Nevertheless, the study clearly indicates the risk of foodborne salmonellosis associated with consumption of contaminated poultry and poultry products in the region.

Rotavirus Infection and Genotyping in Yantai, Shandong Province, 2017-2019.

Rotavirus (RV) ranked first among infectious diarrhea-causing pathogens in Yantai from 2017 to 2019. This study investigated the seroserotypes of RV in Yantai, Shandong, from 2017 to 2019 to identify the dominant serotypes and explore the epidemic pattern, aiming to effectively reduce the infection rate, better guide vaccination, and help in epidemiological prevention and control. A total of 2227 human diarrhea samples were collected from 2017 to 2019 in Yantai. The VP7 (G serotype) and VP4 (P serotype) genes of 467 RV-positive samples were amplified using two-round nested reverse transcription-polymerase chain reaction for G/P genotyping. The genotyping results of RV in Yantai from 2017 to 2019 revealed that G9 was the dominant serotype for all G serotypes, P[8] was the dominant serotype for all P serotypes, and G9P[8] was the dominant serotype for all G/P combinations. G9 serotype accounted for 60.84%, 95.65%, and 83.76% of the total RV samples collected in 2017, 2018, and 2019, respectively. P[8] accounted for 75.52%, 94.69%, and 88.89% of the RV-positive samples collected in 2017, 2018, and 2019, respectively. G9P[8] accounted for 60.84%, 94.69%, and 83.76% of the total RV samples collected in 2017, 2018, and 2019, respectively. Of the total 467 samples from 2017 to 2019, G2P[4] accounted for 3.64% (17/467), G3P[8] for 1.28% (6/467), and G1P[8] for 0.86% (4/467). This study revealed the epidemiological characteristics of RV infection and the development pattern of dominant serotypes in Yantai in recent years, guiding the selection of RV vaccines. The prioritization of vaccines containing G9 serotype for infants in Yantai in recent years is recommended.

Cholera Outbreak 2022 in Karachi: A Report on Serotype and Antibiotic Susceptibility Pattern.

To identify the bacterial agent responsible for the surge of cases of acute diarrhoeal disease in Karachi, Pakistan, and assess the antimicrobial susceptibility pattern of the isolates. Observational study. Department of Microbiology, Indus Hospital & Health Network, Karachi, Pakistan, from 1st March to 31st May 2022. Vibrio cholerae (V. Cholerae) isolates from stool samples received in the laboratory in the months of March, April, and May were identified and antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion method. Serology was performed to identify the serotype causing a surge in cases of acute watery diarrhoea. A total of three-hundred and seventy-eight stool samples were received during the study period, out of which seventy-eight were positive for V. cholerae serogroup O1 serotype Ogawa. The isolate tested 100% sensitive for Ciprofloxacin, Tetracycline, Doxycycline, and Azithromycin, while 74% resistance was observed in Trimethoprim/Sulfamethoxazole and 25% resistance in Ampicillin. V. cholerae serogroup O1 serotype Ogawa was the causative agent responsible for cholera outbreak in Karachi during the early summer of 2022. Ciprofloxacin, Tetracycline, Doxycycline, and Azithromycin are appropriate antimicrobials for treatment; whereas resistance to Trimethoprim/Sulfamethoxazole, and Ampicillin was higher. Vibrio cholerae, Outbreak, Acute diarrhoeal disease.

A Commentary on Salmonella From a Pre-Harvest Perspective

Salmonella occurs in all the major meat producing livestock species (ruminants, swine and poultry), most often residing within the gastrointestinal tract asymptomatically. While considerable success has been achieved post-harvest, the design of effective pre-harvest interventions to control Salmonella has lagged. A simplistic view of the extremely complex host/pathogen interaction suggests that the pathogen has a vested interest in not causing illness or death to the host. The former would initiate an immune response from the host and/or the application of therapeutic antibacterial agents, while the latter would require finding another suitable host. Due to the widespread prevalence of Salmonella within livestock and poultry, and the relatively few salmonellosis cases in comparison, it appears, and is supported by new research, that Salmonella has developed methods to avoid detection by the animal’s immune system and live essentially as a commensal organism within the gastrointestinal tract of the animal. Yet, for reasons that are not fully understood, this “commensal” Salmonella does on occasion become virulent, in young and mature animals alike. Indeed, these researchers have documented Salmonella carriage throughout the year in cattle, but only rarely, if at all, was salmonellosis observed. Further, evaluation of Salmonella isolates (serotype and antimicrobial resistance patterns) from sick and healthy cattle failed to explain that while Salmonella was present in the majority of cattle sampled on that farm, only a few developed salmonellosis. Virulence, as well as multi-drug resistance, in both livestock and humans appears to cluster within a few serotypes. As a result, petitions are circulating calling for the labeling of some Salmonella serotypes as adulterants, as was done with Escherichia coli O157:H7 and other enterohemorrhagic E. coli strains. Regulators are considering approaching the Salmonella problem by serotype, such as focusing specifically on the top 10 reported serotypes causing human illness. Herein, the authors will discuss the many challenges of controlling Salmonella pre-harvest, reflecting on the significant research portfolio that has been generated over the last 25 years, as well as challenging existing paradigms surrounding this pathogen and the experimental methods used to further our understanding of Salmonella and/or evaluate methods of control.

Antimicrobial Susceptibility Pattern and Serotype Distribution of Streptococcus pneumoniae Isolates From a Hospital-Based Study in Chandigarh, North India.

Streptococcus pneumoniae (pneumococcus) causes significant infection-related morbidity and mortality worldwide. The genome plasticity of pneumococcus is an essential factor in antibiotic resistance, serotype switching, and the emergence of nonvaccine serotypes. Information regarding the serotype distribution as well as antimicrobial susceptibility in pneumococcus clinical isolates responsible for various infections in Northern India is limited. Here, we have explored the antibiotic resistance and serotype pattern associated with S. pneumoniae infections from both invasive and noninvasive sites of patients of all ages, visiting out-patient department of a tertiary care hospital (PGIMER, Chandigarh, India). This study was carried out on 68 S. pneumoniae isolates and the isolates exhibited the highest resistance (76.5%) to cotrimaxozole followed by resistance toward tetracycline (36.8%) and erythromycin (23.5%). All isolates showed vancomycin susceptibility and 86.8% of isolates showed sensitivity to chloramphenicol. Multidrug resistance was found in 32% (n=22) of the S. pneumoniae isolates showing resistance toward three different antibiotics. Serotype 19F was found to be the most prevalent serotype (39%) followed by serotypes 6A/B/C (19%) and 1 (12%). These data shed light on the latest trends in antibiotic susceptibility and prevalent serotype patterns of hospital-based S. pneumoniae isolates. This information can be helpful in designing future disease-preventive strategies.

Dengue Status in a Tertiary Care Rural Hospital

Introduction: Dengue is one the most common arthropod-borne virus-transmitted disease of the tropics. Though many remains asymptomatic, a huge population gets infected with some persons leading to a serious form of the disease. As rapid urbanization allows to thrive the Aedes albopictus mosquito which is mainly involved for the transmission of the disease, seasonal outbreaks are becoming a common fact to deal Acute Febrile Illnesses year after year. Aims/Objectives: To study the epidemiology of dengue through the serological, demographic profile, regional distribution, vectors and circulating serotypes. Materials and Methods: Demographic data and presenting symptoms of fever 10476 cases reported to the clinic were recorded. Suspected patients were tested for dengue, chikungunya, scrub typhus and malaria. Dengue-specific NS1 and IgM ELISAs were performed, followed by RNA extraction, PCR and sequencing to detect circulating DENV serotypes. Results: Of the 10476 fever patients tested from July to September 2021, 2767 cases were Dengue NS1 positive, while 2624 were Dengue IgM positive. Of the 200 samples analyzed, 19.1% had concurrent infection with multiple dengue serotypes DEN 1,2 & 3; 63.8% was DEN 1, and 18.2% was DEN 2. Conclusion: Wardha is endemic to Dengue, and concurrent infections with multiple DENV serotypes have become a frequent finding in this region. The most prevalent febrile illness nowadays is Scrub typhus or Dengue Fever in the rural part of central India, which has predominantly replaced typhoid fever and malaria. They may be asymptomatic or give rise to undifferentiated fever, Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF), or Dengue Shock Syndrome (DSS). Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide. It is essential to know the prevalent serotype and disease pattern for better recovery of the patients. Though much research is ongoing for a new vaccine against Dengue, reaching rural India will take time and effort. Early recognition and prompt initiation of appropriate treatment are vital if disease-related morbidity and mortality are to be limited.

Nasopharyngeal carriage, serotype pattern and antimicrobial non-susceptibilities of Streptococcus pneumoniae among healthy children in the 13-valent pneumococcal conjugate vaccine era in Barbados, one of the Caribbean countries

BackgroundBarbados like other countries in the English-speaking Caribbean introduced the 7-valent pneumococcal conjugate vaccine (PCV7) in late 2007, replaced by the 13-valent vaccine (PCV13) in 2013, using a 3+ 0 dosing schedule. We investigated the prevalence and serotype pattern of nasopharyngeal (NP) carriage of Streptococcus pneumoniae (SP) and the Antimicrobial Non-susceptibility of SP (ANSP) among children. Materials and methodsA cross sectional survey of NP carriage. NP swabs were collected from healthy children (6 months to 10 years) attending the well-child clinic at the polyclinics, after parental consent, during 2016–2017. Samples were cultured for SP and isolates were serotyped by the capsular swelling method using commercial group- and type-specific sera. Susceptibility testing was conducted by broth microdilution MIC determination, according to CLSI recommended breakpoints. ResultsPrevalence of NP carriage of SP among 198 healthy children, 88.9% immunized for PCV, was 12.6% (95% CI=8.5%, 18.3%). Prevalence of NP carriage for the VT and NVT was 7.1% (95% CI=4.1%, 11.8%) and 5.6% (95%CI=3.0%, 10.0%) respectively. Serotype 19F was the most common NP isolate in 7 (28%; 12.9%, 49.6%) children and this was followed by 15B/C (25%), 35B (12%) and 6B (12.5%). More than 50% of isolates exhibited Antimicrobial Non-sensitive SP (ANSP) to Penicillin (Oral), Azithromycin and Co-trimoxazole. Serotypes 19F, 19A and 23F showed high level ANSP to 10/11 commonly used antibiotics. ConclusionsNP carriage of SP among healthy children immunized with PCV continues to be predominantly VT and exhibit high ANSP.

Nasopharyngeal carriage, serotype pattern and antimicrobial non-susceptibilities of Streptococcus pneumoniae among healthy children in the 13-valent pneumococcal conjugate vaccine era in Barbados, one of the Caribbean countries

BackgroundBarbados like other countries in the English-speaking Caribbean introduced the 7-valent pneumococcal conjugate vaccine (PCV7) in late 2007, replaced by the 13-valent vaccine (PCV13) in 2013, using a 3+ 0 dosing schedule. We investigated the prevalence and serotype pattern of nasopharyngeal (NP) carriage of Streptococcus pneumoniae (SP) and the Antimicrobial Non-susceptibility of SP (ANSP) among children. Materials and methodsA cross sectional survey of NP carriage. NP swabs were collected from healthy children (6 months to 10 years) attending the well-child clinic at the polyclinics, after parental consent, during 2016–2017. Samples were cultured for SP and isolates were serotyped by the capsular swelling method using commercial group- and type-specific sera. Susceptibility testing was conducted by broth microdilution MIC determination, according to CLSI recommended breakpoints. ResultsPrevalence of NP carriage of SP among 198 healthy children, 88.9% immunized for PCV, was 12.6% (95% CI=8.5%, 18.3%). Prevalence of NP carriage for the VT and NVT was 7.1% (95% CI=4.1%, 11.8%) and 5.6% (95%CI=3.0%, 10.0%) respectively. Serotype 19F was the most common NP isolate in 7 (28%; 12.9%, 49.6%) children and this was followed by 15B/C (25%), 35B (12%) and 6B (12.5%). More than 50% of isolates exhibited Antimicrobial Non-sensitive SP (ANSP) to Penicillin (Oral), Azithromycin and Co-trimoxazole. Serotypes 19F, 19A and 23F showed high level ANSP to 10/11 commonly used antibiotics. ConclusionsNP carriage of SP among healthy children immunized with PCV continues to be predominantly VT and exhibit high ANSP.

Prevalence, serotyping and drug susceptibility patterns of Escherichia coli isolates from kidney transplanted patients with urinary tract infections.

BACKGROUNDExtended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) are among the main pathogens in urinary tract infections (UTIs) among kidney transplant patients (KTPs).AIMTo estimate the prevalence of ESBL-producing E. coli in KTPs and to evaluate the most prevalent serotypes and antibacterial susceptibility patterns of isolated bacteria in Tehran, Iran.METHODSA total of 60 clinical isolates of uropathogenic E. coli were collected from 3 kidney transplant centers from April to May 2019. Antimicrobial susceptibility testing was performed by the disk diffusion method as recommended by the Clinical Laboratory and Standards Institute. The serotyping of E. coli isolates was performed by the slide agglutination method. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by polymerase chain reaction.RESULTSThe frequency of ESBL-producing E. coli in KTPs was found to be 33.4%. All of the 60 E. coli isolates were found to be susceptible to doripenem (100%) and ertapenem (100%). High resistance rates to ampicillin (86%), cefotaxime (80%), and cefazolin (77%) were also documented. The most frequent serotypes were serotype I (50%), serotype II (15%), serotype III (25%), and serotype VI (10%). The gene most frequently found was blaTEM (55%), followed by blaCTX-M (51%) and blaSHV (41%).CONCLUSIONMolecular analysis showed that blaTEM was the most common ESBL-encoding gene. The high resistance to β-lactams antibiotics (i.e., ampicillin, cefotaxime, and cefazolin) found in E. coli from KTPs with UTIs remains a serious clinical challenge. Further efforts to control ESBL-producing E. coli should include the careful use of all antibiotics as well as barrier precautions to reduce spread.

Serotype Patterns of Pneumococcal Disease in Adults Are Correlated With Carriage Patterns in Older Children.

The importance of specific serotypes causing invasive pneumococcal disease (IPD) differs by age. Data on pneumococcal carriage in different age groups, along with data on serotype-specific invasiveness, could help explain these age-related patterns and their implications for vaccination. Using pneumococcal carriage and disease data from Israel, we evaluated the association between serotype-specific IPD in adults and serotype-specific carriage prevalence among children in different age categories, while adjusting for serotype-specific invasiveness. We estimated carriage prevalence using different age groupings that were selected a priori. The Deviance Information Criterion was used to determine which age groupings of carriage data best fit the adult IPD data. Serotype-specific disease patterns were further evaluated by stratifying IPD data by comorbidity status. The relative frequency of serotypes causing IPD differed between adults and children, and also differed between older and younger adults and between adults with and without comorbidities. Serotypes overrepresented as causes of IPD in adults were more commonly carried in older children compared with younger children. In line with this, the serotype-specific frequency of carriage in older children, rather than infants, best correlated with serotype-specific IPD in adults. These analyses demonstrate that the serotype patterns in carriage in older children, rather than infants, are best correlated with disease patterns in adults. This might suggest these older children are more influential for disease patterns in adults. These insights could help in optimizing vaccination strategies to reduce disease burden across all ages.

Molecular Serotyping and Antibiotic Resistance Patterns of Escherichia coli Isolated in Hospital Catering Service in Morocco.

Escherichia coli is related to foodborne disease and outbreaks worldwide. It mainly affects persons at high risk as newborns, infants, and individuals with impaired immune system in hospitals. Multidrug-resistant E. coli is currently spreading both in community and hospital settings. Our study aims to evaluate the presence of E. coli and the incidence of its antibiotic resistance in samples obtained from various cooked and raw foods (N = 300), food contact surfaces (N = 238), and food handlers (N = 40) in Moroccan hospital catering service. E. coli was identified using API 20E, and the antibiotic resistance patterns were obtained using the agar disk diffusion methods. However, PCR method was used for O157 and H7 typing. The samples analysis showed that 14.33%, 24.16%, and 45% of food, surfaces, and food handlers harbored E. coli, respectively, with the highest rates obtained in raw meats (34.88%) and salads (34.88%). Molecular amplification shows that 14 E. coli isolates carried the flagellar antigen H7, while there are no isolates showing amplification for O157. The high rate of resistance was noted against ampicillin (100%), amoxicillin-clavulanate acid (100%), nalidixic acid (61.62%), and cefotaxime (59.49%), and isolates obtained from food handler's hands showed the highest rates of resistance. None of the isolates are extended-spectrum beta-lactamases producing, while 27.7% of the isolates were metallo-beta-lactams producing. This first study conducted on Moroccan hospital catering services may draw the authorities' attention to the necessity of setting up a surveillance system to monitor the food preparation process and the safety of prepared food in healthcare settings.

Streptococcus agalactiae in pregnant women: serotype and antimicrobial susceptibility patterns over five years in Eastern Sicily (Italy)

Streptococcus agalactiae (also known Group B Streptococcus or GBS) represents the main pathogen responsible for early- and late-onset infections in newborns. The present study aimed to determine the antimicrobial susceptibility pattern and the capsular serotypes of GBS isolated in Eastern Sicily over 5 years, from January 2015 to December 2019. A total of 3494 GBS were isolated from vaginal swabs of pregnant women (37–39 weeks), as recommended by the Centers for Disease Control and Prevention. Capsular polysaccharide’s typing of GBS was determined by a commercial latex agglutination test containing reagents to serotypes I–IX. The antimicrobial resistance pattern of GBS was determined through the disk diffusion method (Kirby-Bauer) and the double-disk diffusion test on Mueller-Hinton agar plates supplemented with 5% defibrinated sheep blood, according to the guidelines of the Clinical and Laboratory Standards Institute. Serotypes III (1218, 34.9%) and V (1069, 30.6%) were the prevalent colonizers, followed by not typable (570, 16.3%) and serotypes Ia (548, 15.7%), Ib (47, 1.3%), II (40, 1.1%), and IV (2, 0.1%). All 3494 clinical isolates were susceptible to cefditoren and vancomycin. Resistance to penicillin, ampicillin, levofloxacin, clindamycin, and erythromycin was observed in 6 (0.2%), 5 (0.1%), 161 (4.6%), 1090 (31.2%), and 1402 (40.1%) of the strains, respectively. Most of erythromycin-resistant GBS (1090/1402) showed the cMLSB phenotype, 276 the M phenotype, and 36 the iMLSB phenotype. Our findings revealed a higher prevalence of serotype III and a relevant resistance rate, among GBS strains, to the most frequently used antibiotics in antenatal screening.

Molecular Capsular Typing and Multi Locus Sequence Typing of Invasive, Non-invasive and Commensal Streptococcus pneumoniae Isolates from North India

AbstractPurpose: The purpose of this study is to determine the antimicrobial susceptibility pattern, serotype distribution and sequence type (ST) of Streptococcus pneumoniae isolates from invasive and non-invasive infection and correlate it with isolates from commensal nasopharyngeal flora to ascertain their role in infection. Materials and Methods:S. pneumoniae isolates from blood, cerebrospinal fluid, pleural fluid and respiratory secretions (sputum, bronchoalveolar lavage and nasopharyngeal swab/throat swab) were analysed to determine ST, serotype and antimicrobial susceptibility pattern. Serotyping was performed by multiplex polymerase chain reactions as well as by quellung reaction. Antimicrobial susceptibility testing was determined using Kirby Bauer’s disc diffusion method as per the Clinical Laboratory Standards Institute guidelines. Minimum inhibitory concentration was determined using E-test for penicillin. Multilocus sequence typing (MLST) was done to understand genetic relatedness and evolutionary relationship among strains. Results: A total of 125 S. pneumoniae isolates were collected, including 25 from invasive pneumococcal disease, 25 from non-invasive and 75 from nasopharyngeal swab of healthy children (Commensal). Resistance to penicillin, erythromycin, and co-trimoxazole was observed in 14.4%, 12% and 81.6% of the isolates, respectively, by KirbyBauer’s disc diffusion method. Serotype 14 was found to be the most prevalent in invasive and non-invasive isolates, while serotype 6 was the most common in commensal isolates. New STs were found among invasive (ST13826, ST13827), non-invasive (ST13823, ST13824, and ST13961) and commensal (ST13825) isolates. Conclusion: MLST sequence analysis shows that invasive isolates were found to be clustered with non-invasive and commensal isolates. Analysis of MLST suggests the possibility of genetic relatedness and exchange of genetic material between invasive, non-invasive and commensal isolates.

Serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease isolates from children in mainland China-a systematic review.

This study aimed to review and report the serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease (IPD) isolates, as this information is important for policy making since China has not adopted any pneumococcal vaccines in the national immunization schedule. A systematic review of the published literature from January 2000 to December 2018 was performed to identify articles that describe the serotype and/or antimicrobial resistance patterns of IPD cases in children in mainland China. Analysis of the extracted data was performed with the Microsoft Excel spreadsheet program. The percentage of the serotypes was calculated by dividing the number of isolates for each serotype with the total number of isolates included in all the studies. The theoretical impact of the vaccine was estimated by calculating the percentage of isolates that exhibited the serotypes included in the vaccines. The prevalence of antimicrobial resistance was defined as the number of isolates that were resistant divided by the total number of isolates tested for resistance to the specific antimicrobial agent. Forty-two articles were screened in the preliminary search, of which sixteen fulfilled inclusion criteria and were included in the final analysis. The predominant serotypes were 19A, 19F, 14, 23F, and 6B, and the estimated impact of PCV13 was 90.4%. The isolates exhibited a high frequency of resistance to cefuroxime, cefaclor, and erythromycin. It is necessary for Chinese children to receive PCV13. Clinical workers should pay attention to the high frequency of resistance to antimicrobial agents.

Identifying emerging trends in antimicrobial resistance using Salmonella surveillance data in poultry in Spain.

Despite of controls and preventive measures implemented along the food chain, infection with non‐typhoidal Salmonella (NTS) remains one of the major causes of foodborne disease worldwide. Poultry is considered one of the major sources of NTS. This has led to the implementation of monitoring and control programmes in many countries (including Spain) to ensure that in poultry flocks infection is kept to a minimum and to allow the identification and monitoring of circulating NTS strains and their antimicrobial resistance (AMR) phenotypes. Here, we investigated the information from the monitoring programme for AMR in Salmonella from poultry in Spain in 2011–2017 to assess the diversity in phenotypic resistance and to evaluate the programme's ability to detect multi‐resistance patterns and emerging strains in the animal reservoir. Data on serotype and AMR to nine antimicrobials obtained from 3,047 NTS isolates from laying hens (n = 1,060), broiler (n = 765) and turkey (n = 1,222) recovered during controls performed by the official veterinary services and food business operators were analysed using univariate and multivariate methods in order to describe host and serotype‐specific profiles. Diversity and prevalence of phenotypic resistance to all but one of the antimicrobials (colistin) were higher in NTS from broiler and turkey compared with laying hen isolates. Certain combinations of serotype and AMR pattern (resistotype) were particularly linked with certain hosts (e.g. susceptible Enteritidis with laying hens, multi‐drug resistant (MDR) Derby in turkey, MDR Kentucky in turkey and broiler). The widespread presence of certain serotype‐resistotype combinations in certain hosts/years suggested the possible expansion of MDR strains in the animal reservoir. This study demonstrates the usefulness of the analysis of data from monitoring programmes at the isolate level to detect emerging threats and suggests aspects that should be subjected to further research to identify the forces driving the expansion/dominance of certain strains in the food chain.

Evolution of serotypes in bacteremic pneumococcal adult pneumonia in the period 2001–2014, after introduction of the pneumococcal conjugate vaccine in bizkaia (spain)

The introduction of pneumococcal conjugate vaccines (PCV7 and PCV13) in children has led to a change in the pattern of pneumococcal serotypes causing pneumococcal disease in adults. The aim of this study is to analyze the distribution of pneumococcal serotypes in adults with bacteremic pneumococcal community-acquired pneumonia (BPP) after the introduction of PCVs in childhood, and the impact of age and comorbidity on this distribution. We conducted an observational study of all adults hospitalized with BPP between 2001 and 2014, in two tertiary hospitals. Overall, we identified 451 cases of BPP (2001–2005: 194, 2006–2010: 134, 2011–2014: 123). The rate of appearance of new cases decreased over the study period. In 70% of the cases, the serotypes found were among those included in PCV13. The most prevalent serotypes were 3 (23.1%), 7F (14.6%), 19A (8.4%) and 1 (7.5%). There was a significant trend to decrease in the percentage of BPP cases due to PCV7 from period 2001–2005 to 2011–2014 (p = 0.0166) and a significant trend to increase in the six serotypes added to form PCV 13 (p = 0.0003). Serotype 3 was the most frequent in patients who developed complications during hospitalization. We did not detect a significant increase in cases caused by non-PCV13 serotypes. The most frequent non-PCV13 serotype was 22F. In conclusion, a significant proportion of adults continue to develop BPP with vaccine serotypes despite infant pneumococcal vaccination. There is a need for further strategies to reduce the current burden of this disease on adults.

An alarmingly high nasal carriage rate of Streptococcus pneumoniae serotype 19F non-susceptible to multiple beta-lactam antimicrobials among Vietnamese children

BackgroundUnderstanding the relationship between serotype epidemiology and antimicrobial susceptibility of Streptococcus pneumoniae is essential for the effective introduction of pneumococcal conjugate vaccines (PCVs) and control of antimicrobial-resistant pneumococci.MethodsWe conducted a community-based study in Nha Trang, central Vietnam, to clarify the serotype distribution and pattern of S. pneumoniae antimicrobial susceptibility in children under 5 years of age and to identify risk factors for carrying antimicrobial-resistant strains. Nasopharyngeal swabs collected from children with acute respiratory infections (ARIs) hospitalized between April 7, 2008, and March 30, 2009, and from healthy children randomly selected in July 2008 were subjected to bacterial culture. Minimum inhibitory concentrations (MICs) against S. pneumoniae were determined, and multiplex-polymerase chain reaction (PCR) serotyping assays were performed. Logistic regression was applied to identify risk factors.ResultsWe collected 883 samples from 331 healthy children and 552 ARI cases; S. pneumoniae was isolated from 95 (28.7%) healthy children and 202 (36.6%) ARI cases. Age and daycare attendance were significantly associated with pneumococcal carriage. In total, 18.0, 25.8 and 75.6% of the isolates had high MICs for penicillin (≥4 μg/ml), cefotaxime (≥2 μg/ml) and meropenem (≥0.5 μg/ml), respectively. The presence of pneumococci non-susceptible to multiple beta-lactams was significantly associated with serotype 19F (Odds Ratio: 4.23) and daycare attendance (Odds Ratio: 2.56) but not ARIs, age or prior antimicrobial use. The majority of isolates non-susceptible to multiple beta-lactams (90%) were PCV13 vaccine serotypes.ConclusionsS. pneumoniae serotype 19F isolates non-susceptible to multiple beta-lactams are widely prevalent among Vietnamese children. Vaccine introduction is expected to significantly increase drug susceptibility.

Dominant serotype distribution and antimicrobial resistance profile of Shigella spp. in Xinjiang, China.

Shigella represents one of the major diarrhea-inducing pathogens threatening public health, but its prevalence and antimicrobial resistance profile in Xinjiang Uygur Autonomous region, China, remains unclear. We conducted comprehensive investigation of Shigella serotype distribution and antimicrobial resistance pattern in Xinjiang, identifying 458 Shigella isolates between 2008 to 2014. Shigella flexneri was identified as predominant species, and several S. flexneri serotypes were isolated, including atypical serotypes 1c, 2c, and 4s. Dominant S. flexneri serotypes were 2a, 1b, 2b, and Xv, different from those generally dominant in China. A hybrid serotype pattern was observed, which included the major Chinese serotypes (2a, Xv) and those predominant in Pakistan (1b, 2b). Shigella sonnei was shown to have a lower frequency compared with that generally observed in China, but an increasing trend of infections associated with this pathogen was observed. Furthermore, a high frequency of drug resistance and different Shigella antimicrobial resistance patterns were demonstrated as well, including very severe resistance phenotypes, such as multidrug resistance and resistance to frontline antibiotics. Seventy-five cephalosporin-resistant Shigella isolates were frequently identified with the resistance determinants that can undergo horizontal transfer, such as blaOXA, blaTEM, blaCTX-M, and integrons, facilitating the development of cephalosporin resistance among Shigella subtypes. Additionally, genetic analyses demonstrated that all 86 quinolone-resistant S. flexneri isolates possess 3–4 mutation sites in quinolone resistance-determining regions, primarily contributing to their resistance to quinolone. However, S. sonnei isolates were not shown to be quinolone resistant. Co-resistance to cephalosporins and quinolones was detected in 17 S. flexneri isolates, and these isolates were additionally multidrug resistant and carried β-lactamase genes and quinolone-resistance determinants. As is demonstrated in this study, dominant serotypes of Shigella were distributed in unique trend with dangerous drug resistance patterns. Novel strategies are urgently required to prevent the development of drug resistance among diarrhea-inducing pathogens.