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[Susceptibility to antimicrobial agents in isolates from invasive Streptococcus pneumoniae in Colombia]
1Instituto Nacional de Salud, Grupo de Microbiología, Santa Fe de Bogotá, Colombia.
Abstract:
A study was done to determine the patterns of susceptibility to antimicrobial agents in isolates of Streptococcus pneumoniae that caused invasive disease diagnosed in children under the age of 5 in Colombia between 1994 and 1996, as well as to establish the distribution of the capsular types of the resistant isolates. The analysis was done using 324 isolates obtained during the performance of the National Serotyping Protocol for S. pneumoniae carried out in Bogotá, Medellín, and Cali, Colombia, between July 1994 and March 1996. Of the 324 isolates, 119 (36.7%) showed diminished susceptibility to at least one antimicrobial agent, including 39 (12%) that showed diminished susceptibility to penicillin. Of these 39 resistant to penicillin, 29 showed intermediate resistance and 10 showed high resistance. Nine isolates (2.8%) showed resistance to ceftriaxone, 80 (24.7%) to the combination of trimethoprim and sulfamethoxazole (TMS), 49 (15.1%) to chloramphenicol, and 31 (9.6%) to erythromycin. Resistance to two antimicrobial agents was observed in 31 isolates (9.6%); multiple resistance was found in 22 (6.7%). These 22 multiresistant isolates all showed resistance to TMS. The most frequent associations were penicillin, TMS, and erythromycin (5 cases); penicillin, chloramphenicol, TMS, and erythromycin (4 cases); penicillin, ceftriaxone, chloramphenicol, and TMS (3 cases); and penicillin, ceftriaxone, chloramphenicol, TMS, and erythromycin (3 cases). The most frequent serotypes in the penicillin-resistant isolates were: 23F (53.8%), 14 (25.6%), 6B (7.7%), 9V (5.1%), 19F (5.1%), and 34 (2.6%). The most frequent serotypes in the isolates resistant to antimicrobial agents other than penicillin were: 5 (37.5%), 23F (7.5%), 14 (18.8%), and 6B (13.8%). This difference in the distribution of the serotypes was statistically significant (P < 0.0001). The study results indicate the need to maintain active surveillance of antibiotic susceptibility patterns in order to avoid resistance in S. pneumoniae and to provide timely information to change practices regarding prescribing and consuming antimicrobial agents.
Insights
Invasive Streptococcus pneumoniae in Colombian children showed significant antimicrobial resistance, particularly to trimethoprim-sulfamethoxazole and penicillin. Capsular type distribution varied between penicillin-resistant and other resistant isolates, highlighting the need for ongoing surveillance.
Area of Science:
- Microbiology and Infectious Diseases
- Pediatric Infectious Diseases
- Antimicrobial Resistance Surveillance
Context:
- Study conducted in Colombia (1994-1996) analyzing 324 Streptococcus pneumoniae isolates from invasive diseases in children under 5.
- Investigated antimicrobial susceptibility patterns and capsular type distribution among resistant isolates.
Purpose:
- To determine antimicrobial susceptibility patterns in Streptococcus pneumoniae causing invasive disease in young Colombian children.
- To establish the distribution of capsular types among antibiotic-resistant S. pneumoniae isolates.
Summary:
- 119 out of 324 isolates (36.7%) exhibited reduced susceptibility to at least one agent; 39 (12%) were resistant to penicillin.
- High resistance rates were observed for trimethoprim-sulfamethoxazole (24.7%) and chloramphenicol (15.1%). Multiple resistance was found in 22 isolates (6.7%), all resistant to trimethoprim-sulfamethoxazole.
- Significant differences (P < 0.0001) in capsular serotype distribution were noted between penicillin-resistant (e.g., 23F, 14) and other resistant isolates (e.g., 5, 14, 6B).
Impact:
- Findings underscore the critical need for continuous surveillance of antibiotic susceptibility in S. pneumoniae.
- Results can inform antimicrobial prescribing practices and consumption patterns to mitigate emerging resistance.
- Identified specific serotypes associated with resistance, aiding targeted public health interventions.