Streptococcus pneumoniae serotype distribution and antimicrobial resistance profile in South Gujarat, India: Preliminary regional surveillance study.

INTRODUCTION

Data on Streptococcus pneumoniae serotype distribution and antibiotic resistance in South Gujarat, India, are limited. This study investigated pneumococcal serotypes, antibiotic resistance patterns, and their associations with age and theoretical vaccine coverage.

METHODOLOGY: Among 550 processed clinical specimens, 27 (4.9%) yielded S. pneumoniae. Isolates were identified using VITEK 2 Compact, confirmed by conventional methods, tested for antimicrobial susceptibility, and serotyped. Age-wise serotype distribution and theoretical vaccine coverage were also analyzed.

RESULTS

High resistance was observed for erythromycin (89%), followed by tetracycline (67%), trimethoprim/sulfamethoxazole (59%), and clindamycin (48%). Lower resistance rates were observed for benzylpenicillin (22%), cefotaxime (22%), ceftriaxone (19%), levofloxacin (7%), and moxifloxacin (4%). All isolates were susceptible to vancomycin, tigecycline, rifampicin, chloramphenicol, and linezolid. Multidrug resistance (MDR) was observed in 67% of the pneumococcal isolates. MDR prevalence was highest (100%) among patients aged 45-65 years, whereas a lower MDR prevalence (40%) was observed among children aged 5-15 years. The S. pneumoniae 19F serotype was identified as the most predominant MDR serotype (26%), followed by serotypes 1 (11%), 3/9V/14/22F (7%), and 5/6A/6C/7B/10A/18C/19A/23B/24B (4%). The theoretical coverage rates of PCV7, PCV10, PCV13, Pneumosil, and PPSV23 were 44%, 59%, 74%, 63%, and 81%, respectively.

CONCLUSIONS

The significant burden of MDR S. pneumoniae in South Gujarat highlights the need for antimicrobial stewardship and continuous monitoring of serotype distribution and resistance patterns in the region. These results provide important baseline epidemiological data for this region.