Nasopharyngeal carriage of Streptococcus pneumoniae in Romanian children before the introduction of the pneumococcal conjugated vaccination into the national immunization programme: a national, multi-centre, cross-sectional observational study

Objectives: We analysed the distribution of vaccine and non-vaccine Streptococcus pneumoniae serotypes and the antimicrobial susceptibility of pneumococcal strains isolated from healthy Romanian children. Methods: A multi-centre cross-sectional study was performed in four counties to evaluate carried strains of S. pneumoniae isolated from 2000 children aged 0–5 years. Results: S. pneumoniae carriage was detected in 25.25% of the tested children. Carriage increased from 16.7% among infants to 29.4% in 3–5-year-old children (p 0.064 mg/l were recorded in 71.6%, but the penicillin MIC was >2 mg/l for only 8.4% of tested isolates. Conclusions: In Romanian children, the majority of carried S. pneumoniae isolates are vaccine serotypes. The isolates with MICs defining macrolide resistance were very frequent, as well as the isolates with MICs defining penicillin resistance in the case of meningitis or penicillin dose-dependent susceptibility for other infections, mainly for the strains belonging to PCV13 serotypes. The implementation of PCV13 within the Romanian national immunization programme could reduce the circulation of these strains with higher macrolide and/or penicillin MICs

EVALUATION OF FOUR PHENOTYPIC TESTS FOR THE DETECTION OF OXA-48-TYPE CARBAPENEMASE IN ENTEROBACTERIACEAE

Carbapenemase-producing Enterobacteriaceae have the potential to rapid dissemination in healthcare settings, becoming a major infection control and public health concern. PCR remains the reference method for identifying these strains, but is still expensive. We evaluated the performance of four phenotypic tests for identifying OXA-48-producing (Oxacillinase-48) Enterobacteriaceae. These were modified Hodge test (MHT), a combination disk test with meropenem alone or in combination with various inhibitors and temocillin, an enzymatic test and an immunochromatographic test. The tests were performed and interpreted according to guidelines or manufacturer’s recommendations. The most frequent microorganism included in the study was Klebsiella pneumoniae. All the tests had 100% specificity, except MHT (87,5%). Sensitivity was 91,25% for MHT, 90% for the combination disk test, 95% for the enzymatic test and 82,50% for the immunochromatographic test