WHO recommends the inclusion of PCVs in childhood vaccination programs world-wide. Many countries including the Russian Federation are currently planning the inclusion of PCVs in their National Immunization Programs and, therefore, data on the pneumococcal serotype distribution is important to estimate the potential disease impact. Here we review eight recent epidemiological studies on the pneumococcal serotype distribution from Russia. Across all studies, serotypes 6B, 14, 19F and 23F were the most prevalent. Interestingly, serotype 3 was relatively common. Serotype 19A was prevalent among AOM, CAP and nasopharyngeal isolates and among antibiotic resistant isolates in all age groups. The differences in serotype coverage between PCV10 and PCV13 were up to 26%. Based on the current data on serotype distribution, a wide use of PCVs in Russia may lead to a significant reduction of the pneumococcal disease burden.

Objective. To evaluate antimicrobial resistance patterns of clinical Haemophilus influenzae isolates from different regions of Russia during 2014–2017. Materials and Methods. We included in the study 185 clinical H. influenzae isolates from 13 Russian cities. Susceptibility testing was performed by reference broth microdilution method (ISO 207761:2006). Susceptibility testing results were interpreted using EUCAST v. 10.0 breakpoints. Results. H. influenzae isolates were highly susceptible to all (96.8%-100%) β-lactams tested (amoxicillin/ clavulanate, cefixime, ceftaroline, ceftibuten, cefditoren, ertapenem) with the exception of ampicillin (15.1% isolates were resistant). Fluoroquinolones, – ciprofloxacin, levofloxacin, moxifloxacin were active against 95.7%, 94.6% and 97.9% of isolates, respectively. Chloramphenicol was active against 97.9% of isolates, tetracycline – against 98.4% of isolates. Activity of trimethoprim/sulfamethoxazole was low (69.2% of susceptible isolates). Conclusions. In general, we can state the favorable situation with the susceptibility of H. influenzae to antimicrobials in Russia. However, the increasing of resistance to aminopenicillins and emerging of quinolone-resistant strains could become a problem in the future. Study Results are deposited at on-line resource AMRmap (http://AMRmap.ru).

Objective. To evaluate antimicrobial resistance patterns of clinical Streptococcus pneumoniae isolates from different regions of Russia during 2014–2017. Materials and Methods. We included in the study 519 clinical S. pneumoniae isolates from 18 Russian cities. Susceptibility testing was performed by reference broth microdilution method (ISO 20776-1:2006). Susceptibility testing results were interpreted according to EUCAST v.9.0 breakpoints. Results. Using EUCAST non-meningeal interpretation criteria, 65.1% of isolates tested were susceptible (S) to penicillin; in addition 28.

Purpose: antigenic and genetic characterization of Streptococcus pneumoniae strains isolated from patients with invasive forms of pneumococcal infection using whole-genome sequencing.Materials and Methods. The study was performed on 46 S. pneumoniae strains isolated during the PEHASus multicenter studies in 2015-2018. Sequencing was performed using Illumina protocols and equipment. The SPAdes, SeroBA, PneumoCaT software were used for data processing, as well as BIGSdb software (PubMLST.org).Results and Discussion. Whole-genome sequences of strains were obtained; the information was entered into the PubMLST database (id: 51080-51125). Ten (21%) strains were found to have serotype 3. Five (11%) strains belonged to serotype 19F and five to serogroup 6; two of them belonged to serotype 6A; one strain had 6B and 1 had 6BE serotype; 1 strain showed discordant result (6A or 6BE). Serotype 15B was identified in 3 (6.5%) strains. Serotypes 7F, 8, 9V, 14, 22F, 23F and 28A were identified in two strains each; serotypes 1, 4, 9N, 10C, 12F, 18C, 35F, 37 and 38 were found once. The proportion of strains with serotypes included in PCV13 and PPV23 vaccines was 65% and 80%, respectively. 36 sequence types were found in strains; out of them, 6 sequence types were found for the first time. A dominant sequence type or clone complexes could not be identified using multilocus sequence typing except for serotype 3 strains. The inability to identify clonal complexes is in congruence with the previously obtained data on the absence of S. pneumoniae clones associated with pneumococcal meningitis in Russia.Conclusion. The information about serotypes of S. pneumoniae causing invasive infections together with epidemiologic data about strain sources and vaccination allows us to evaluate the effectiveness of pneumococcal vaccines and provide information for improving the PCR-based routine serotyping.

Objective. To estimate prevalence and antimicrobial susceptibility of circulated S. pneumoniae serotypes in adult population in different regions of the Russian Federation. Materials and Methods. A total of 500 isolates of S. pneumoniae obtained from patients with invasive pneumococcal disease (IPD), community-acquired pneumonia (CAP), sinusitis/acute otitis media (AOM) and healthy carriers from 29 centers were included in the study from 01 June 2019 to 15 January 2020. Re-identification, typing using real-time PCR with 27 primer pairs and antimicrobial susceptibility testing were performed in the central laboratory by standardized methods. Results. Among 50 isolates from patients with IPD, the following serotypes were detected: 3 (20.0%), 23F (10.0%), 6ABCD (8.0%), 19F (6.0%), 12ABF, 4, 7AF, 8, 9NL, 9VA, 15B (4.0% each), 1, 10A, 11AD, 14, 15AF, 18ABCF, 22AF, 33F/33A/37 (2.0% each). PCV-13 and PPV-23 covered 62.0% and 86.0% of those serotypes, respectively. Among 357 isolates from patients with CAP, the following serotypes were detected: 19F (12.3%), 6ABCD (11.5%), 3 (10.1%), 23F (5.9%), 14 (5.3%), 22AF (5.0%), 11AD (4.8%), 9NL (3.4%), 15AF (2.8%), 9VA (2.2%), 18ABCF (2.0%), 19A (1.7%), 12ABF (1.4%), 17F (0.8%), 16, 33F/33A/37, 7AF and 8 (0.6% each), 10A and 4 (0,3% each); serotypes were not specified due to the PCR typing protocol limitations for 106 (29.8%) isolates. PCV-13 and PPV-23 covered 51.9% and 68.7% of those serotypes, respectively. In patients with sinusitis/AOM (n = 48), serotypes were: 19F (18.8%), 6ABCD (16.7%), 23F (12.5%), 3 (12.5%), 18ABCF (6.3%), 11AD (4.2%), 14 (4.2%), 22AF (4.2%), 15AF, 4, 9VA (2.1% each). PCV-13 and PPV-23 covered 75.0% and 83.3% of those serotypes, respectively. In healthy nasopharyngeal carriers (n = 45), the following serotypes were detected: 19F (24.4%), 3 (17.8%), 6ABCD (17.8%), 11AD (13.3%), 23F (8.9%), 22AF (6.7%), 14 and 15AF (2.2% each). PCV-13 and PPV-23 covered 71.1% and 91.1% of those serotypes, respectively. Serotypes 14, 19F, and 19A were frequently resistant to three antibiotics – penicillin, erythromycin, and tetracycline. Resistance to respiratory quinolones was very low (0.7%) and detected among serotypes 14 and 9NL only. The majority of non-vaccine serotypes did not have substantial antimicrobial resistance problems. Conclusions. Despite the relatively low number of isolates in all but CAP group and limitations of PCR typing protocol, results of our study support the use of pneumococcal vaccines (PPV-23 and PCV-13) in Russian adult population, with some advantages of PPV-23 over PCV-13.

Objective. To estimate the prevalence of S. pneumoniae serotypes in adults aged of 18 years and older, including healthy carriers and patients with acute otitis media (AOM), community-acquired pneumonia (CAP) and invasive pneumococcal infection (IPI). Materials and Methods. A total of 230 isolates of S. pneumoniae from 10 centers were included in the study from 01.06.2019 to 01.10.2019. Re-identification and typing using real-time PCR with 22 primer pairs were performed in the central laboratory (Institute of Antimicrobial Chemotherapy, Russia). Results. In healthy nasopharyngeal carriers (n = 31), the following serotypes of S. pneumoniae were detected: 19F (29.0%), 6А/В (22.6%), 3 (16.1%), 11A/D and 23F (9.7% each), 23A (6.4%), 14 and 15A/F (3.2% each); PCV-13 and PPV-23 covered 80.6% and 90.3% of those serotypes, respectively. In patients with AOM (n = 18), serotypes were: 3 (16.7%), 11A/D and 6A/B (11.1%, each), 16, 19А, 19F, 23F, 7A/F (5.55%, each); PCV-13 and PPV-23 covered 50% and 61.1% of those serotypes, respectively. Among 166 isolates from patients with CAP, the following serotypes were detected: 3 (12.0%), 19F and 6A/B (10.2%, each), 14 and 11A/D (5.4% each), 15A/F and 23A (4.8% each), 9N/L (4.2%), 18 and 22A/F (2.4% each), 19A and 23F (1.8% each), 16, 9V/A (1.2% each), 4 and 33A/33F/37 (0.6% each), non-vaccine serotypes (30.3%); PCV-13 and PPV-23 covered 45.6% and 57.0% of those serotypes, respectively. Isolates from patients with IPI (n=15) belonged to the following serotypes: 3 (26.7%), 12F, 23F and 9N/L (13.3% each), serotypes 4 and 15A/F (6.7%), non-vaccine serotype – 1 isolate (6.7%); PCV-13 and PPV-23 covered 46.7% and 73.3% of those serotypes, respectively. Conclusions. The majority of S. pneumoniae serotypes in adult population in Russia are included in PPV-23, but not in PCV-13 (primarily due to serotype 11A/D). There was a high PCV-13 and PPV-23 coverage of serotypes from healthy nasopharyngeal carriers. PPV-23 covered more than 60% of clinical isolates, whereas PCV-13 covered less than 60% (AOM – 50.0%, CAP – 45.6%, IPI – 46.7%), thus indicating a potentially lower efficacy of PCV-13 in adult population.