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A significant increase in antimicrobial resistance among pneumococci causing invasive disease in New Zealand
1Communicable Disease Group, Institute of Environmental Science and Research, Porirua.
Aims:
To review the prevalence of antibiotic resistance and the distribution of capsular types among pneumococci from invasive disease in New Zealand from 1995 through 1997.
Method:
Pneumococci isolated from sterile sites that were referred to the Institute of Environmental Science and Research (ESR) were tested for antimicrobial susceptibility and capsular type.
Results:
A total of 994 pneumococci were referred by 27 hospital and community laboratories. Almost 74% of the isolates were from patients aged < 15 years or > or = 60 years. The majority (88.2%) of the isolates were from blood cultures. In 1997, cefotaxime-resistant pneumococci were confirmed for the first time from invasive disease in New Zealand. Over the three years, 6.0% of the pneumococci were penicillin-nonsusceptible (MIC > or = 0.12 mg/L) and 3.7% were cefotaxime-nonsusceptible (MIC > or = 1 mg/L). Penicillin nonsusceptibility increased significantly from 1.9% in 1995 to 6.2% in 1996 and 9.9% in 1997. Similarly, cefotaxime nonsusceptibility increased from 0.6% in 1995 to 3.5% in 1996 and 6.9% in 1997. In descending order of frequency, the ten most common capsular types were 14, 19, 6, 9, 1, 4, 18, 7, 23, and 3. Eighty-three percent of the penicillin-nonsusceptible pneumococci belonged to serotypes 9V, 19A, 19F, 23F, 14 and 6B and 90% belonged to serotypes included in the 23-valent vaccine.
Conclusions:
The increasing prevalence of antimicrobial resistance among pneumococci highlights the need for continued surveillance and for effective measures to prevent pneumococcal infections.
Insights
Antibiotic resistance in pneumococci is rising in New Zealand, with significant increases in penicillin and cefotaxime nonsusceptibility observed between 1995 and 1997. This trend underscores the urgent need for ongoing surveillance and infection prevention strategies.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Streptococcus pneumoniae causes invasive diseases globally.
- Antibiotic resistance in pneumococci is a growing public health concern.
- Understanding resistance patterns and serotype distribution is crucial for effective treatment and prevention.
Purpose of the Study:
- To determine the prevalence of antibiotic resistance in pneumococci causing invasive disease in New Zealand.
- To analyze the distribution of capsular types among these pneumococcal isolates.
- To track trends in antimicrobial resistance from 1995 to 1997.
Main Methods:
- Pneumococcal isolates from sterile sites were collected from 27 laboratories across New Zealand.
- Antimicrobial susceptibility testing was performed on all isolates.
- Capsular typing was conducted to identify pneumococcal serotypes.
Main Results:
- Over 994 pneumococci isolates were analyzed, primarily from blood cultures.
- A significant increase in penicillin and cefotaxime nonsusceptibility was observed from 1995 to 1997.
- Commonly found capsular types included 14, 19, 6, 9, 1, 4, 18, 7, 23, and 3, with many resistant strains belonging to serotypes covered by the 23-valent vaccine.
Conclusions:
- The study confirms a concerning rise in antibiotic resistance among invasive pneumococcal isolates in New Zealand.
- Specific serotypes, often included in current vaccines, are associated with resistance.
- Continuous surveillance and enhanced prevention measures are essential to combat the increasing threat of antimicrobial resistance.