Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae isolates cultured from Japanese adult patients with community-acquired pneumonia in Goto City, Japan

Taiga Miyazaki; Mark van der Linden; Katsuji Hirano; Takahiro Maeda; Shigeru Kohno; Elisa N Gonzalez; Pingping Zhang; Raul E Isturiz; Sharon L Gray; Lindsay R Grant; Michael W Pride; Bradford D Gessner; Luis Jodar; Adriano G Arguedas

doi:10.3389/fmicb.2024.1458307

Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae isolates cultured from Japanese adult patients with community-acquired pneumonia in Goto City, Japan

Front Microbiol. 2024 Sep 24:15:1458307. doi: 10.3389/fmicb.2024.1458307. eCollection 2024.

Authors

Taiga Miyazaki^{1

2}, Mark van der Linden³, Katsuji Hirano^{1

4}, Takahiro Maeda¹, Shigeru Kohno¹, Elisa N Gonzalez⁵, Pingping Zhang⁵, Raul E Isturiz⁵, Sharon L Gray⁵, Lindsay R Grant⁵, Michael W Pride⁶, Bradford D Gessner⁵, Luis Jodar⁵, Adriano G Arguedas⁵

Affiliations

¹ Nagasaki University, Nagasaki, Japan.
² Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
³ German Reference Laboratory for Streptococci, Department of Medical Microbiology, University Hospital RWTH, Aachen, Germany.
⁴ National Center for Global Health and Medicine, Tokyo, Japan.
⁵ Pfizer Inc., Collegeville, PA, United States.
⁶ Pfizer Inc., Pearl RiverNew York, NY, United States.

Abstract

Streptococcus pneumoniae is an important cause of community-acquired pneumonia (CAP) in Japan. Here, we report the serotype distribution and antimicrobial susceptibility of cultured pneumococcal isolates from Japanese adults aged ≥18 years with CAP. This was a prospective, population-based, active surveillance study conducted in Goto City, Japan from December 2015 to November 2020. Pneumococcal isolates from sterile sites (blood and pleural fluid) and non-sterile sites (sputum and bronchoalveolar lavage) were cultured as part of the standard of care. S. pneumoniae were serotyped using the Quellung reaction. Antimicrobial susceptibility was tested using microdilution and interpreted according to the Clinical and Laboratory Standards Institute criteria. Isolates resistant to erythromycin were phenotyped using the triple-risk test and genotyped by polymerase chain reaction. A total of 156 pneumococcal isolates were collected (138 from sputum, 15 from blood, and 3 from bronchoalveolar lavage) from 1992 patients. Of these, 142 were non-duplicate isolates from unique patients and were included in the analyses. Serotypes contained within the 13-valent pneumococcal conjugate vaccine (PCV13) (including 6C), PCV15 (including 6C), and PCV20 (including 6C and 15C) were detected in 39 (27%), 45 (32%), and 80 (56%) of 142 isolates, respectively. The most common serotypes were 35B (12%), 11A (11%), and 3 (11%). Multidrug resistance (MDR) was detected in 96/142 (68%) isolates. Of the 96 MDR isolates, 31, 32, and 59% were PCV13, PCV15, and PCV20 serotypes, respectively; the most common MDR serotypes were 35B (16%), 6C, 10A, and 15A (9% each), and 3 and 11A (8% each). A total of 119 isolates were resistant to macrolides; 41 (35%) had an M phenotype, 53 (45%) had an iMcLS phenotype, and 25 (21%) had a cMLS phenotype. In conclusion, pneumococcal serotypes 35B, 11A and 3 were most frequently associated with pneumonia and antimicrobial resistance was common among pneumococcal isolates from adults with CAP in Goto City, Japan. Implementing higher-valency PCVs May help reduce vaccine-type CAP among Japanese adults.

Keywords: PCV; Streptococcus pneumoniae; antimicrobial susceptibility; community-acquired pneumonia; pneumococcal vaccination.

Grants and funding

The authors declare that this study received funding from Pfizer. The funder was involved with study concept, analysis; drafting of the first draft of manuscript; and the decision to submit the manuscript for publication. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.