Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018

Figures & data

Figure 1. The map of Turkey that geographically represents the study centres and the included isolates from each centre.

Table 1. Year-wise number of isolates obtained from 21 centres included in the study.

	2015	2016	2017	2018	Total
Marmara University, Pendik Training and Research Hospital, Department of Medical Microbiology, Istanbul, Turkey	26	17	16	13	72
Dokuz Eylul University, Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey	27	22	0	0	49
Hacettepe University, Faculty of Medicine Department of Medical Microbiology, Ankara, Turkey	11	15	13	9	48
Cukurova University, Faculty of Medicine, Department of Medical Microbiology, Adana, Turkey	15	8	13	4	40
Istanbul University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Istanbul, Turkey	8	6	11	3	28
Ege University, Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey	7	10	7	3	27
Karadeniz Technical University, Faculty of Medicine, Department of Medical Microbiology, Trabzon, Turkey	8	7	4	7	26
Antalya Training and Research Hospital, Department of Medical Microbiology, Antalya, Turkey	0	0	6	15	21
Akdeniz University, Faculty of Medicine, Department of Medical Microbiology, Antalya, Turkey	5	0	11	4	20
Samsun Ondokuz Mayıs University, Faculty of Medicine, Department of Medical Microbiology, Samsun, Turkey	9	0	3	6	18
Bursa Uludag University, Faculty of Medicine, Department of Medical Microbiology, Bursa, Turkey	1	7	3	6	17
Dicle University Faculty of Medicine, Department of Medical Microbiology, Diyarbakir, Turkey	3	4	5	4	16
Ankara Yuksek Ihtisas Training and Research Hospital, Department of Clinical Microbiology, Ankara, Turkey	2	2	0	1	5
Gaziantep University, Faculty of Medicine, Department of Microbiology, Gaziantep, Turkey	1	3	1	0	5
Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Department of Microbiology and Clinical Microbiology, Istanbul, Turkey	0	2	0	3	5
Kayseri City Training and Research Hospital, Department of Medical Microbiology, Kayseri, Turkey	0	0	2	3	5
Eskişehir Osmangazi University, Faculty of Medicine, Department of Medical Microbiology, Eskişehir, Turkey	0	2	0	0	2
Kahramanmaraş Sutcu Imam University, Faculty of Medicine, Department of Medical Microbiology, Kahramanmaraş, Turkey	2	0	0	0	2
Mersin University, Faculty of Medicine, Department of Medical Microbiology, Mersin, Turkey	1	0	0	1	2
İzmir Tepecik Training and Research Hospital, Pediatric Infectious Diseases Clinic, Izmir, Turkey	0	0	1	0	1
Yüzüncü Yıl University, Faculty of Medicine, Department of Medical Microbiology, Van, Turkey	0	1	0	0	1
Total	126	106	96	82	410

Figure 2. Serotypes covered by PCV13, PCV15, PCV20 and PPV23.

Figure 3. Changes in antibiotic non-susceptibility in years.

Table 2. Antibiotic non-susceptibility according to age groups.

	Age groups
	<65 years n (%)	≥65 years n (%)	Total n (%)
Penicillin (non-meningitis)	10 (4.1)	6 (4.8)	16 (4.3)
Penicillin (meningitis)	17 (70.8)	8 (57.1)	25 (65.8)
Penicillin (oral penicillin V)	149 (55.4)	75 (53.2)	224 (54.6)
Cefotaxime (meningitis)	6 (25.0)	2 (14.3)	8 (21.1)
Cefotaxime (non-meningitis)	9 (3.7)	7 (5.5)	16 (4.3)
Erythromycin	103 (38.3)	54 (38.3)	157 (38.2)
Moxifloxacin	2 (0.8)	3 (2.1)	5 (1.2)

Table 3. Distribution of isolated serotypes according to age groups.

	Age groups
Serotypes	<65 years N = 269	≥65 years N = 141	Total N = 410
	n (%)	n (%)	n (%)
1	26 (9.7)	12 (8.5)	38 (9.3)
2	2 (0.7)	–	2 (0.5)
3	32 (11.9)	26 (18.4)	58 (14.1)
4	5 (1.9)	1 (0.7)	6 (1.5)
5	5 (1.9)	2 (1.4)	7 (1.7)
6 A	9 (3.3)	10 (7.1)	19 (4.6)
6B	2 (0.7)	–	2 (0.5)
6B/D	3 (1.1)	–	3 (0.7)
6 D	1 (0.4)	1 (0.7)	2 (0.5)
7B	1 (0.4)	1 (0.7)	2 (0.5)
7F	8 (3)	6 (4.3)	14 (3.4)
8	4 (1.5)	8 (5.7)	12 (2.9)
9A	1 (0.4)	–	1 (0.2)
9N	3 (1.1)	2 (1.4)	5 (1.2)
9V	7 (2.6)	8 (5.7)	15 (3.7)
10A	3 (1.1)	1 (0.7)	4 (1)
10B	1 (0.4)	–	1 (0.2)
10C	1 (0.4)	–	1 (0.2)
11A	7 (2.6)	5 (3.5)	12 (2.9)
11B	2 (0.7)	–	2 (0.5)
11C	1 (0.4)	2 (1.4)	3 (0.7)
11F	3 (1.1)	–	3 (0.7)
12	–	1 (0.7)	1 (0.2)
12A	1 (0.4)	1 (0.7)	2 (0.5)
12F	2 (0.7)	1 (0.7)	3 (0.7)
14	14 (5.2)	1 (0.7)	15 (3.7)
15	2 (0.7)	–	2 (0.5)
15A	5 (1.9)	3 (2.1)	8 (2)
15B	4 (1.5)	2 (1.4)	6 (1.5)
15F	1 (0.4)	1 (0.7)	2 (0.5)
16F	–	1 (0.7)	1 (0.2)
17A	2 (0.7)	–	2 (0.5)
17F	8 (3)	2 (1.4)	10 (2.4)
18C	1 (0.4)	–	1 (0.2)
18F	4 (1.5)	–	4 (1)
19A	8 (3)	7 (5)	15 (3.7)
19B	1 (0.4)	–	1 (0.2)
19F	35 (13)	14 (9.9)	49 (12)
20	1 (0.4)	2 (1.4)	3 (0.7)
22A	1 (0.4)	1 (0.7)	2 (0.5)
22F	4 (1.5)	3 (2.1)	7 (1.7)
23B	3 (1.1)	–	3 (0.7)
23F	17 (6.3)	6 (4.3)	23 (5.6)
24A	–	1 (0.7)	1 (0.2)
24F	1 (0.4)	–	1 (0.2)
28A	–	1 (0.7)	1 (0.2)
28F	1 (0.4)	–	1 (0.2)
33B	–	1 (0.7)	1 (0.2)
33C	1 (0.4)	–	1 (0.2)
33F	2 (0.7)	2 (1.4)	4 (1)
35B	4 (1.5)	–	4 (1)
35C	3 (1.1)	–	3 (0.7)
35F	11 (4.1)	3 (2.1)	14 (3.4)
Other^a	5 (1.9)	2 (1.4)	7 (1.7)

^aNon-typeable serotypes (1 non-typeable serotype, 1 non-typeable G+ serotype, 3 non-typeable E+ serotypes for <65 years; 2 non-typeable E+ serotypes for ≥65 years).

Table 4. Coverage of pneumococcal vaccines according to age groups.

	<65 years n (%)	≥65 years n (%)	Total n (%)
BAL
PCV13	61 (59.8)	35 (62.5)	96 (60.8)
PCV15	62 (60.8)	38 (67.9)	100 (63.3)
PCV20	69 (67.6)	45 (80.4)	114 (72.2)
PPV23	72 (70.6)	46 (82.1)	118 (74.7)
IPD
PCV13	108 (64.7)	58 (68.2)	166 (65.9)
PCV15	113 (67.7)	60 (70.6)	173 (68.7)
PCV20	122 (73.1)	68 (80.0)	190 (75.4)
PPV23	128 (76.6)	65 (76.5)	193 (76.6)

Note: BAL: bronchoalveolar lavage; IPD: invasive pneumococcal disease.

Figure 4. Comparison of the coverage of pneumococcal vaccines.

Data availability statement

The data that support the findings of this study are available from the corresponding author, Gulsen Hascelik, upon reasonable request.