Penicillin resistance and serotype distribution of Streptococcus pneumoniae in Kuwait: implications for treatment and prevention

Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait

^* To whom correspondence should be addressed. Email: e.mokaddas{at}hsc.edu.kw.

	Abstract

Streptococcus pneumoniae causes serious infections. Treatment is made difficult by the emergence of penicillin resistance in S. pneumoniae. Pneumococcal vaccines offer the promise of control and prevention of pneumococcal infections. Serotype prevalence and penicillin susceptibility data in a country will predict the usefulness of the vaccines in that country. In Kuwait, the 23- valent polysaccharide and the 7- valent conjugate vaccines are being used without the knowledge of prevalent serotypes in the country. To obtain the necessary background information, data on penicillin susceptibility and serogroups were obtained on 397 consecutive clinical isolates collected during 2004-2005. Two hundred and fifty-three (64%) isolates were penicillin-resistant, and resistance was significantly higher in patients 15 years old and among the upper respiratory and eye isolates. The commonest serotypes were 23F, 19F, 6A, 6B, 14 and 19A. Among the penicillin resistant strains, the commonest serotypes were 23F, 19F, 6B, 14 and 9A. Among the invasive strains, the commonest serotypes were 14, 23F, 19A and 9V. The polysaccharide vaccine gave 82% coverage against invasive infections in all age groups > 2 years old. The coverage of the 7- valent conjugate vaccine against invasive serotypes in children 2 years old was 55%. This moderate coverage against invasive infections in children by the conjugate vaccine necessitates a revised strategy on the use of the present conjugate vaccine and the need for formulation of an improved vaccine for superior coverage for Kuwait and possibly other countries of the Arabian Gulf.