AUTHOR=Guo Meng-Yang , Shi Xing-Hai , Gao Wei , Tian Ju-Ling , Yuan Lin , Yang Juan , Wumaier Dilinuer , Cao Jiang , Abulimiti Reziwaguli , Zhang Wen-Li , Yao Kai-Hu 

TITLE=The dynamic change of serotype distribution and antimicrobial resistance of pneumococcal isolates since PCV13 administration and COVID-19 control in Urumqi, China

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1110652

DOI=10.3389/fcimb.2023.1110652

ISSN=2235-2988

ABSTRACT=Objective To analyze the serotype distribution and drug resistance of Streptococcus pneumoniae isolated from children aged from 8-day to 7-year in Urumqi, China between 2014 to 2021, during which the PCV13 was introduced in private sector of immunization program and COVID-19 control was administrated in the last two years. 
Methods Serotypes of S.pneumoniae isolates were determined by Quellung reaction, and their susceptibility against 14 antimicrobials were tested. According to the start year of PCV13 administration (2017) and COVID-19 control (2020), the study period was divided into three stages: 2014-2015, 2018-2019 and 2020-2021. 
Results A total of 317 isolates were involved into this study. The most common serotypes were type 19F (34.4%), followed by 19A (15.8%), 23F (11.7%), 6B (11.4%) and 6A(5.0%). The coverage rates of PCV13 and PCV15 both were 83.0%. The coverage of PCV20 was a little higher at 85.2%. The resistance rate against penicillin was 28.6% according to the breakpoints of oral penicillin, which would reach up to 91.8% based on the breakpoints of parenteral penicillin for meningitis. The resistance rates to erythromycin, clindamycin, tetracycline and sulfamethoxazole-trimethoprim were 95.9%, 90.2%, 88.9% and 78.8 respectively. The PCV13 isolates was more resistant to penicillin than the non-PCV13 ones. The serotype distribution was not found any significant change since the PCV13 introduction and the COVID-19 control. The resistance rate against oral penicillin slightly elevated to 34.5% in 2018-2019 from 30.7% in 2014-2015, and then decreased significantly to 18.1% in 2020-2021(2=7.716，P<0.05), while the resistant rate to ceftriaxone (non-meningitis) continuously declined from 16.0% in 2014-2015 to 1.4% in 2018-2019 and 0% in 2020-2021 (Fisher=24.463, P<0.01).
Conclusion The common serotypes of S. pneumoniae isolated from children in Urumqi were type 19F, 19A, 23F, 6B and 6A, which was not found marked change since the PCV13 introduction and the COVID-19 control However, the resistance rate to oral penicillin and ceftriaxone significantly declined in the COVID-19 control stage.