Version 3: Nasopharyngeal carriage rate, serotype distribution, and antimicrobial profiles of Streptococcus pneumoniae among patients with acute respiratory tract infection in Manado, North Sulawesi, Indonesia

We studied the carriage rate, distribution of serotype, and antimicrobial profile of Streptococcus pneumoniae (S. pneumoniae) among patients with acute respiratory tract infections (ARTI) in two primary health centers and a tertiary referral hospital from 2019 to 2020 in Manado, North Sulawesi, Indonesia before 13-valent PCV (PCV13) introduction. 106 nasopharyngeal swab samples were collected from children and adult patients. Serotyping of S. pneumoniae strain was performed with sequential multiplex PCR and Quellung reaction. Antimicrobial profile was performed by the disk diffusion method. We identified thirty-one patients carried S. pneumoniae strains (29%). The S. pneumoniae carriage rate was found to be higher among children aged 2-5 years (13/32; 40.6%) than in children under 1 year (8/27; 29.6%), children and adolescents under 18 years of age (5/20; 25.0%) and adult patients (5/27; 18.5%). The distribution of serotypes varied, including 14, 18C, 19A, 23F, 19F and 35B (two strains each) and 1, 3, 6B, 6C, 31, 9V, 15C, 16F, 17F, 23A, 35F (one strain each) and non-typeable (9/31; 29%). We found S. pneumoniae isolates were susceptible to vancomycin (30/31; 97%), chloramphenicol (29/31; 94%), clindamycin (29/31; 94%), erythromycin (22/31; 71%), azithromycin (22/31; 71%), tetracycline (14/31; 45%), penicillin (11/31; 35%), and sulfamethoxazole/trimethoprim (10/31; 32%). This study provides supporting baseline data on distribution of serotype and antimicrobial profile of S. pneumoniae among patients with ARTI before PCV13 introduction in Manado, North Sulawesi, Indonesia.