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Serotype distribution & antimicrobial resistance in Streptococcus pneumoniae causing invasive & other infections in
1Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India.
Background & Objectives:
Streptococcus pneumoniae continues to be a major cause of morbidity and mortality in developing countries. The emerging resistance to some common antibiotics compounds the problem. There arises a need to monitor the resistance pattern and map serotype distribution in different geographic locations. The present study was undertaken to determine the serotype prevalence and antibiotic susceptibility of clinically significant S. pneumoniae isolated from a tertiary care hospital in south India.
Methods:
A total of 150 clinical isolates from invasive and other clinically significant pneumococcal infections were serotyped and screened for susceptibility to commonly used antibiotics by standard and modified laboratory procedures.
Results:
Majority (59.3%) of the isolates belonged to one or other of the serotypes 1, 6, 19, 5, 23 and 7. Serotype 1 was the commonest isolate from patients of meningitis and empyema followed by pneumonia. Nineteen isolates (12.6%) were nonvaccine type. Eleven (7.3%) isolates were relatively resistant to penicillin (minimum inhibitory concentration was between 0.1 and 1 microgram/ml) and 64 were resistant to one or more antibiotics. Resistance was distributed equally among the predominant serotypes.
Interpretation & Conclusion:
The common serotypes responsible for significant infections were similar to those reported in some other studies from India, with minor variations. Resistance to cotrimoxazole and tetracycline was predominant followed by chloramphenicol. Low level resistance to penicillin was observed but no isolate had absolute resistance. This calls for monitoring of resistance and mapping of serotype distribution from various parts of India.
Insights
Antibiotic resistance in Streptococcus pneumoniae is a growing concern in India. This study found common serotypes and significant resistance to cotrimoxazole and tetracycline, highlighting the need for ongoing surveillance.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Streptococcus pneumoniae is a leading cause of illness and death in developing nations.
- Increasing antibiotic resistance complicates treatment and necessitates resistance pattern monitoring.
- Understanding serotype distribution is crucial for effective disease control strategies.
Purpose of the Study:
- To determine the serotype prevalence of clinically significant S. pneumoniae isolates.
- To assess the antibiotic susceptibility patterns of these isolates.
- To provide data from a tertiary care hospital in South India.
Main Methods:
- Serotyping of 150 clinical isolates from pneumococcal infections.
- Screening for antibiotic susceptibility using standard and modified laboratory methods.
- Analysis of resistance patterns against commonly used antibiotics.
Main Results:
- Serotypes 1, 6, 19, 5, 23, and 7 accounted for 59.3% of isolates.
- Serotype 1 was most common in meningitis and empyema cases.
- 12.6% of isolates were non-vaccine types; 7.3% showed penicillin resistance, and 64% were resistant to at least one antibiotic.
Conclusions:
- Predominant serotypes align with other Indian studies, with minor variations.
- High resistance rates were observed for cotrimoxazole and tetracycline, followed by chloramphenicol.
- Low-level penicillin resistance necessitates continuous monitoring of resistance and serotype distribution across India.