A Laboratory-Based Surveillance Study of Invasive <i>Neisseria meningitidis</i>, <i>Streptococcus pneumoniae</i>, and <i>Haemophilus influenzae</i> Diseases in a Serbian Pediatric Population—Implications for Vaccination
Snezana Delic,
Vera Mijac,
Ina Gajic,
Dusan Kekic,
Lazar Ranin,
Boris Jegorovic,
Davor Culic,
Valentina Cirkovic,
Marina Siljic,
Maja Stanojevic,
Metka Paragi,
Milos Markovic,
Natasa Opavski
Affiliations
Snezana Delic
Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia
Vera Mijac
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Ina Gajic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Dusan Kekic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Lazar Ranin
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Boris Jegorovic
Clinical Centre of Serbia, University Hospital for Infectious and Tropical Diseases, 11000 Belgrade, Serbia
Davor Culic
Centre for Microbiology, National Reference Laboratory for Meningococcus and Haemophilus, Institute of Public Health, 25101 Sombor, Serbia
Valentina Cirkovic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Marina Siljic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Maja Stanojevic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Metka Paragi
National Laboratory of Health Environment and Food, Department for Public Health Microbiology, 1000 Ljubljana, Slovenia
Milos Markovic
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
Natasa Opavski
Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, 11000 Belgrade, Serbia
The aim of this study was to present the epidemiology of invasive diseases caused by Neisseria meningitidis and Streptococcus pneumoniae in the pre-vaccine period, and Haemophilus influenzae in the post-vaccine period in a pediatric population from Serbia. Among the meningococci, serogroup B dominated (83%), followed by serogroup C (11.3%). High antigenic diversity was found, with fine type P1.5-1,10-4 being the most frequent. Moderate susceptibility to penicillin was common (55%). Within pneumococci, serotypes 19F, 14, 6B, 6A, 18C, 23F, 3, and 7F prevailed, while 19A was rare (3.6%). The coverages of PCV10 and PCV13 were 68% and 84%, respectively. Major sequence types were ST320, ST15, ST273, ST271, and ST81. Non-susceptibility to penicillin (66.7%), cefotaxime (37%), and macrolides (55%) was predominantly detected in vaccine-related serotypes. Among the 11 invasive H. influenzae isolates collected, there were six Hib, three non-type b, and two non-typeable strains (ntHi) that were antibiotic susceptible. These results imply a potential benefit of future Men-B vaccine implementations. For pneumococci, as PCV10 was recently introduced, a significant reduction of morbidity and antibiotic resistance might be expected. The efficiency of Hib vaccination is evident, but a shift towards non-type b and ntHi strains may be anticipated.
