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    Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018
    (Taylor and Francis Ltd., 2023) Hasçelik, Gülşen; Söyletir, Güner; Gülay, Zeynep; Sancak, Banu; Akgün, Yaman; Gürler, Nezahat; Akpolat, Nezahat
    Objective:To evaluate the serotype distribution and antibiotic resistance in pneumococcalinfections in adults and to provide a perspective regarding serotype coverage of both currentand future pneumococcal vaccines.Patients and methods:This passive surveillance study was conducted with theStreptococcuspneumoniaestrains isolated from the specimens of patients with pneumonia (materials isolatedfrom bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015and 2018. Serogrouping and serotyping were performed by latex particle agglutination andby conventional Quellung reaction using commercial type-specific antisera, respectively. Thestrains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilitiesby E-test.Results:In the whole study group (410 samples from adults aged 18years), the most frequentserotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15,PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillinnon-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patientsaged<65 and 65 years, respectively. About 21.1% and 4.3% of the patients with and withoutIPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2%and 1.2%, respectively.Conclusions:The results revealed that novel PCV vaccines may provide improved coverage ascompared with the currently available vaccine, PCV13. The significant antibiotic resistance ratesimply the need to extend the serotype coverage of the vaccines. Continuing the surveillance inpneumococcal diseases is critical to explore the serotype distribution and incidence changes ofIPD cases in the population and to inform policy makers to make necessary improvements inthe national immunization programmes.KEY MESSAGES This multicentre study demonstrated the most recent serotype distribution and antibioticresistance in adult population in Turkey.