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A surveillance study on penicillin-resistant streptococcus pneumoniae in China
1Institute of Clinical Pharmacology, First Teaching Hospital of Beijing Medical University, Beijing 100034, China.
Insights
Penicillin-resistant Streptococcus pneumoniae strains have been identified in China, with high resistance rates to macrolides and tetracycline observed in pediatric patients. This highlights a growing concern for antimicrobial resistance in the region.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae is a common cause of pediatric respiratory infections.
- Antimicrobial resistance in S. pneumoniae is a significant global health concern.
- Surveillance of antibiotic resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To determine the prevalence of penicillin-resistant Streptococcus pneumoniae in China.
- To assess the resistance rates of S. pneumoniae to various antimicrobial agents.
- To identify resistance patterns in pediatric patients with respiratory tract infections.
Main Methods:
- A surveillance study was conducted in Beijing, China, involving over 900 pediatric patients.
- Throat swabs were collected and isolates were identified as S. pneumoniae.
- Antibiotic susceptibility testing was performed using disk diffusion and MIC determination.
Main Results:
- Two of 51 S. pneumoniae isolates exhibited penicillin resistance (MICs of 2 mg/L and 4 mg/L).
- High resistance rates were observed for macrolides (erythromycin, clarithromycin, roxithromycin) and tetracycline (100%).
- Resistance to ampicillin, piperacillin, furbenicillin, and cefuroxime was also noted.
Conclusions:
- Penicillin-resistant Streptococcus pneumoniae strains are present in China.
- These resistant strains show cross-resistance to other beta-lactams and high resistance to macrolides and tetracycline.
- The findings underscore the need for ongoing surveillance and updated treatment guidelines for pneumococcal infections in China.
Objectives:
To find out whether there are also penicillin-resistant streptococcus pneumoniae and the resistant rate in China.
Methods:
A surveillance study which is a part of the international surveillance on pneumococci resistance to penicillin and other antimicrobial agents was conducted in Beijing, China. More than 900 pediatric patients with respiratory tract infections aged from six months to three years selected from two pediatric units were enrolled in the study. Perthroat swabs were immediately streaked onto blood agar plates. Isolates were identified as pneumococci by their typical appearance, gram stain, confirmation tests. Antibiotic susceptibility was assessed by the disk diffusion method and minimal inhibition concentration (MIC) determination according to Protocol and National Committee for Clinical Laboratory Standards (NCCLS).
Results:
Of the 51 streptococcus pneumoniae isolates, 5 strains had zones of inhibition indicative of penicillin resistance, of which two had penicillin MICs > or = 0.1 mg/L and were considered to be relatively or fully resistant to penicillin. The MICs of two penicillin resistant strains were 2 mg/L and 4 mg/L. Resistant rates to ceftriaxone and cefotaxime were 0% and 10% respectively. For the other ten antimicrobial agents, the resistant rates were as follows: ampicillin 12%, piperacillin 26%, furbenicillin 14%, cefuroxime 6%, erythromycin 54%, clarithromycin 52%, meleumycin 64%, roxithromycin 52%, chloramphenicol 35%, tetracycline 100%.
Conclusions:
The study suggested that penicillin resistant streptococcus pneumoniae strains existed in China and were also resistant to ampicillin, piperacillin, furbenicillin and cefuroxime. Moreover, the resistant rates of penicillin resistant streptococcus pneumoniae to macrolides and tetracycline were high.