Ben Ayed Nourelhouda, Gargouri Omar, Mhimdi Samar, Smaoui Fahmi, Mhiri Emna, Kanzari Lamia, Zribi Meriam, Maalej Mezghanni Senda, Ktari Sonia, Meftah Khaoula, Mohamed Naglaa, Zaghden Hela, Bahri Olfa, Besbes Sophie, Achour Wafa, Slim Leila, Boutiba Ilhem, Smaoui Hanen, Hammami Adnene
Laboratory of Microbiology, Habib Bourguiba University Hospital Center, Sfax 3000, Tunisia.
Research Laboratory LR03SP03 "Micro-Organisme et Pathologie Humaine", Faculty of Medicine, University of Sfax, Sfax 3029, Tunisia.
Antibiotics (Basel). 2025 Feb 10;14(2):171. doi: 10.3390/antibiotics14020171.
: is a leading respiratory pathogen responsible for significant morbidity and mortality, particularly among vulnerable populations. Understanding its antimicrobial resistance patterns and serotype distribution is crucial for guiding treatment and prevention strategies. This study aims to examine these trends in isolates from Tunisia over a two-decade period (2000-2019). : A retrospective time series analysis was conducted on data (n = 4284) gathered from eight university hospital centers across Tunisia. Antimicrobial susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Pneumococcal serotypes were determined for a subset of samples from 2012 to 2019 (n = 903) using multiplex PCR and latex agglutination. : Penicillin G resistance decreased from 9-13.7% during 2000-2002 to 4.3% by 2019, while amoxicillin resistance increased until reaching 10% in 2019. Erythromycin resistance initially increased before stabilizing between 61.9% and 66.3% during 2014-2019, whereas tetracycline resistance declined from 2000 to 2008 and fluctuated around 40% during 2009-2019. Levofloxacin resistance did not exceed 1.2% throughout the study period. The most prevalent serotypes were 14, 19F, 19A, 23F, 3, 6B, 6A, and 9V. Among them, serotype 3 was the most susceptible overall. Serotypes 23F, 14, 9V, and 6B displayed the highest levels of multi-drug resistance. : Penicillin G (high-dosage), cefotaxime, and levofloxacin are still effective against most strains in Tunisia, while erythromycin and tetracycline are not reliable options for treating pneumococcal infections. Alarming resistance rates among prevalent serotypes, except serotype 3, underscore the need for preventive measures, rational antibiotic use, and ongoing surveillance.
是一种主要的呼吸道病原体，可导致严重的发病率和死亡率，尤其是在弱势群体中。了解其抗菌药物耐药模式和血清型分布对于指导治疗和预防策略至关重要。本研究旨在调查突尼斯20年期间（2000 - 2019年）分离株中的这些趋势。方法：对从突尼斯8家大学医院中心收集的数据（n = 4284）进行回顾性时间序列分析。根据欧洲抗菌药物敏感性测试委员会（EUCAST）指南进行抗菌药物敏感性测试。使用多重PCR和乳胶凝集法对2012年至2019年的一部分样本（n = 903）测定肺炎球菌血清型。结果：青霉素G耐药率从2000 - 2002年的9% - 13.7%降至2019年的4.3%，而阿莫西林耐药率上升，到2019年达到10%。红霉素耐药率最初上升，在2014 - 2019年期间稳定在61.9%至66.3%之间，而四环素耐药率在2000年至2008年下降，在2009 - 2019年期间在40%左右波动。左氧氟沙星耐药率在整个研究期间不超过1.2%。最常见的血清型为14、19F、19A、23F、3、6B、6A和9V。其中，血清型3总体上最敏感。血清型23F、14、9V和6B表现出最高水平的多重耐药性。结论：青霉素G（高剂量）、头孢噻肟和左氧氟沙星对突尼斯的大多数菌株仍然有效，而红霉素和四环素不是治疗肺炎球菌感染的可靠选择。除血清型3外，流行血清型中令人担忧的耐药率凸显了采取预防措施、合理使用抗生素和持续监测的必要性。
