Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022
BackgroundStreptococcus pneumoniae is a major cause of Invasive pneumococcal disease (IPD), including bacteremic pneumonia, septicemia, and meningitis. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly reduced the incidence of IPD caused by vaccine-covered serotypes. Howev...
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Frontiers Media S.A.
2025-03-01
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| author | Larisa Savrasova Anita Villerusa Indra Zeltina Indra Zeltina Indra Zeltina Angelika Krumina Hedija Cupeca Hedija Cupeca Hedija Cupeca Sooria Balasegaram Mara Greve Oksana Savicka Oksana Savicka Solvita Selderina Jelena Galajeva Diana Dushacka |
| author_facet | Larisa Savrasova Anita Villerusa Indra Zeltina Indra Zeltina Indra Zeltina Angelika Krumina Hedija Cupeca Hedija Cupeca Hedija Cupeca Sooria Balasegaram Mara Greve Oksana Savicka Oksana Savicka Solvita Selderina Jelena Galajeva Diana Dushacka |
| author_sort | Larisa Savrasova |
| collection | DOAJ |
| description | BackgroundStreptococcus pneumoniae is a major cause of Invasive pneumococcal disease (IPD), including bacteremic pneumonia, septicemia, and meningitis. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly reduced the incidence of IPD caused by vaccine-covered serotypes. However, serotype replacement and antimicrobial resistance remain concerns. In Latvia, vaccination against pneumococcal disease was introduced into the NIP in 2010 with PCV7, later transitioning to PCV10 in 2012 and to PCV15 in 2024. This study aims is to determine the changes in S. pneumoniae antimicrobial resistance and its association with PCV10 serotypes in Latvia.Materials and methodsWe conducted a population-based cross-sectional study using IPD surveillance data from Latvia over an 11-year period (2012–2022). IPD cases were defined according to the European Union case definition. Serotyping and antimicrobial susceptibility testing were performed on isolates from normally sterile sites. We analyzed the differences in IPD incidence, serotype distribution, and antimicrobial resistance using chi-square tests and multivariable logistic regression was used to determine associations between antimicrobial resistance and risk factors.ResultsA total of 811 IPD cases were reported, with significant differences observed across the study period (p < 0.001). The most common serotypes were 3 and 19A. The proportion of IPD cases caused by PCV10 serotypes significantly decreased over the years, while cases caused by PCV13, PCV15, and PPPV23 serotypes increased. Antimicrobial susceptibility testing revealed resistance rates of 3.8% to penicillin, 5.4% to erythromycin, and 1.2% to cefotaxime/ceftriaxone. Erythromycin resistance showed significant variation over time (p = 0.016), decreasing from 7.1% in 2012 to 4.8% in 2022. Multivariable logistic regression indicated that IPD cases with S. pneumoniae PCV10 serotypes and meningitis were significantly associated with an increased likelihood of penicillin and erythromycin resistance.ConclusionThe study highlights a decrease in erythromycin resistance in IPD cases over time and significant associations between PCV10 serotypes and meningitis in IPD cases and penicillin and erythromycin resistance. The findings underscore the importance of continuous surveillance of S. pneumoniae serotypes and antimicrobial resistance patterns to inform treatment guidelines and vaccination policies. Further research is needed to assess the long-term impact of the PCV15 vaccine on S. pneumoniae serotype distribution and resistance. |
| format | Article |
| id | doaj-art-5d6a3738489246c4ac353f80cd7a62e4 |
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| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-5d6a3738489246c4ac353f80cd7a62e42025-08-20T02:04:27ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-03-011310.3389/fpubh.2025.15018211501821Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022Larisa Savrasova0Anita Villerusa1Indra Zeltina2Indra Zeltina3Indra Zeltina4Angelika Krumina5Hedija Cupeca6Hedija Cupeca7Hedija Cupeca8Sooria Balasegaram9Mara Greve10Oksana Savicka11Oksana Savicka12Solvita Selderina13Jelena Galajeva14Diana Dushacka15Institute of Public Health, Riga Stradinš University, Riga, LatviaInstitute of Public Health, Riga Stradinš University, Riga, LatviaInstitute of Public Health, Riga Stradinš University, Riga, LatviaRiga East University Hospital Riga, Riga, LatviaDepartment of Infectology, Riga Stradiņš University, Riga, LatviaDepartment of Infectology, Riga Stradiņš University, Riga, LatviaInstitute of Public Health, Riga Stradinš University, Riga, LatviaChildren’s Clinical University Hospital, Riga, LatviaDepartment of Human Physiology and Biochemistry, Riga Stradiņš University, Riga, LatviaPublic Health England Field Epidemiology Service South East and London, London, United KingdomStatistics Unit, Riga Stradiņš University, Riga, LatviaInstitute of Public Health, Riga Stradinš University, Riga, LatviaLaboratory “Latvian Centre of Infectious Diseases”, National Microbiology Reference Laboratory, Riga, LatviaLaboratory “Latvian Centre of Infectious Diseases”, National Microbiology Reference Laboratory, Riga, LatviaLaboratory “Latvian Centre of Infectious Diseases”, National Microbiology Reference Laboratory, Riga, LatviaLaboratory “Latvian Centre of Infectious Diseases”, National Microbiology Reference Laboratory, Riga, LatviaBackgroundStreptococcus pneumoniae is a major cause of Invasive pneumococcal disease (IPD), including bacteremic pneumonia, septicemia, and meningitis. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly reduced the incidence of IPD caused by vaccine-covered serotypes. However, serotype replacement and antimicrobial resistance remain concerns. In Latvia, vaccination against pneumococcal disease was introduced into the NIP in 2010 with PCV7, later transitioning to PCV10 in 2012 and to PCV15 in 2024. This study aims is to determine the changes in S. pneumoniae antimicrobial resistance and its association with PCV10 serotypes in Latvia.Materials and methodsWe conducted a population-based cross-sectional study using IPD surveillance data from Latvia over an 11-year period (2012–2022). IPD cases were defined according to the European Union case definition. Serotyping and antimicrobial susceptibility testing were performed on isolates from normally sterile sites. We analyzed the differences in IPD incidence, serotype distribution, and antimicrobial resistance using chi-square tests and multivariable logistic regression was used to determine associations between antimicrobial resistance and risk factors.ResultsA total of 811 IPD cases were reported, with significant differences observed across the study period (p < 0.001). The most common serotypes were 3 and 19A. The proportion of IPD cases caused by PCV10 serotypes significantly decreased over the years, while cases caused by PCV13, PCV15, and PPPV23 serotypes increased. Antimicrobial susceptibility testing revealed resistance rates of 3.8% to penicillin, 5.4% to erythromycin, and 1.2% to cefotaxime/ceftriaxone. Erythromycin resistance showed significant variation over time (p = 0.016), decreasing from 7.1% in 2012 to 4.8% in 2022. Multivariable logistic regression indicated that IPD cases with S. pneumoniae PCV10 serotypes and meningitis were significantly associated with an increased likelihood of penicillin and erythromycin resistance.ConclusionThe study highlights a decrease in erythromycin resistance in IPD cases over time and significant associations between PCV10 serotypes and meningitis in IPD cases and penicillin and erythromycin resistance. The findings underscore the importance of continuous surveillance of S. pneumoniae serotypes and antimicrobial resistance patterns to inform treatment guidelines and vaccination policies. Further research is needed to assess the long-term impact of the PCV15 vaccine on S. pneumoniae serotype distribution and resistance.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1501821/fullStreptococcus pneumoniaeInvasive pneumococcal disease (IPD)serotype replacementantimicrobial resistance (AMR)pneumococcal conjugate vaccines (PCV)surveillance |
| spellingShingle | Larisa Savrasova Anita Villerusa Indra Zeltina Indra Zeltina Indra Zeltina Angelika Krumina Hedija Cupeca Hedija Cupeca Hedija Cupeca Sooria Balasegaram Mara Greve Oksana Savicka Oksana Savicka Solvita Selderina Jelena Galajeva Diana Dushacka Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 Frontiers in Public Health Streptococcus pneumoniae Invasive pneumococcal disease (IPD) serotype replacement antimicrobial resistance (AMR) pneumococcal conjugate vaccines (PCV) surveillance |
| title | Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 |
| title_full | Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 |
| title_fullStr | Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 |
| title_full_unstemmed | Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 |
| title_short | Streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in Invasive pneumococcal disease cases in Latvia, 2012–2022 |
| title_sort | streptococcus pneumoniae serotypes and factors associated with antimicrobial resistance in invasive pneumococcal disease cases in latvia 2012 2022 |
| topic | Streptococcus pneumoniae Invasive pneumococcal disease (IPD) serotype replacement antimicrobial resistance (AMR) pneumococcal conjugate vaccines (PCV) surveillance |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1501821/full |
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