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Nosocomial transmission of penicillin-resistant Streptococcus pneumoniae
N Cimolai1, A Cogswell, R Hunter
1Department of Pediatrics, Children's and Women's Health Centre of British Columbia, Vancouver, Canada. ncimolai@wpog.childhosp.bc.ca
Abstract:
Two patients were found to harbor intermediate-level penicillin-resistant Streptococcus pneumoniae in a pediatric hospital setting. For the first patient, the bacterium was isolated from a tracheal aspirate, and for the second patient, a positive blood culture was found a short time after the index case. Two molecular typing techniques (enterobacterial repetitive intergenic consensus sequence polymerase chain reaction, and repetitive sequence-based polymerase chain reaction) demonstrated homology among these isolates, which suggests person-to-person spread. We propose the need for institution-based infection control precautions that will limit the spread of penicillin-resistant pneumococci.
Insights
Intermediate-level penicillin-resistant Streptococcus pneumoniae was identified in two pediatric patients. Molecular typing confirmed homology, suggesting person-to-person transmission within the hospital setting.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Streptococcus pneumoniae is a common cause of bacterial infections in children.
- Antibiotic resistance in S. pneumoniae is a growing global health concern.
- Intermediate-level penicillin resistance poses challenges for treatment guidelines.
Observation:
- Two pediatric patients in a hospital setting were found to have intermediate-level penicillin-resistant Streptococcus pneumoniae.
- Isolates were obtained from tracheal aspirate from the first patient and blood culture from the second.
- The second case occurred shortly after the first, suggesting a potential link.
Findings:
- Molecular typing techniques, including enterobacterial repetitive intergenic consensus sequence polymerase chain reaction (ERIC-PCR) and repetitive sequence-based polymerase chain reaction (rep-PCR), were employed.
- Both typing methods demonstrated homology between the S. pneumoniae isolates from the two patients.
- This genetic similarity strongly suggests person-to-person transmission within the healthcare facility.
Implications:
- The findings highlight the potential for the spread of penicillin-resistant pneumococci in pediatric hospital environments.
- There is a critical need for robust, institution-based infection control strategies.
- Implementing targeted precautions is essential to limit the transmission and impact of resistant bacterial strains.