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Streptococcus pneumoniae, Brooklyn, New York: fluoroquinolone resistance at our doorstep
John Quale1, David Landman, Jayashree Ravishankar
1State University of New York Downstate Medical Center, Brooklyn, New York 11203, USA.
Abstract:
To examine the resistance rates and epidemiology of Streptococcus pneumoniae in Brooklyn, New York, isolates were collected during two boroughwide surveillance periods in 1997 and 1999. Of 138 isolates, 67% were susceptible to penicillin and 34% to ciprofloxacin. Susceptibility rates to ciprofloxacin decreased dramatically from 1997 to 1999 (47% to 16%, p=0.0003). Five isolates (3.6%) were resistant to levofloxacin. Western Brooklyn had lower rates of susceptibility to penicillin compared with eastern neighborhoods. More isolates in the eastern neighborhoods belonged to the Spanish/French 9/14 clone, and isolates in the western neighborhoods tended to belong to the Spanish/USA 23F clone. Residents of the western neighborhoods were more likely to be white and elderly and less likely to be receiving Medicaid or public assistance, characteristics associated with increased health-care and antibiotic use. Brooklyn residents appear to be at high risk for fluoroquinolone-resistant S. pneumoniae. Our results underscore the need for vigilant regional surveillance.
Insights
Streptococcus pneumoniae resistance to ciprofloxacin increased significantly in Brooklyn between 1997 and 1999. This highlights the urgent need for ongoing surveillance of antibiotic resistance in the region.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Streptococcus pneumoniae is a leading cause of bacterial infections worldwide.
- Antibiotic resistance in S. pneumoniae poses a significant public health threat.
- Understanding regional resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the resistance rates and epidemiology of Streptococcus pneumoniae in Brooklyn, New York.
- To assess changes in antimicrobial susceptibility over time.
- To identify potential risk factors associated with resistance.
Main Methods:
- Collection of S. pneumoniae isolates during two boroughwide surveillance periods in 1997 and 1999.
- Antimicrobial susceptibility testing for penicillin, ciprofloxacin, and levofloxacin.
- Analysis of isolate distribution and clonal types in different Brooklyn neighborhoods.
Main Results:
- Overall susceptibility to penicillin was 67% and to ciprofloxacin was 34%.
- A dramatic decrease in ciprofloxacin susceptibility was observed from 47% in 1997 to 16% in 1999 (p=0.0003).
- Five isolates (3.6%) exhibited resistance to levofloxacin; resistance patterns varied geographically, with western Brooklyn showing lower penicillin susceptibility and a higher prevalence of the Spanish/USA 23F clone.
Conclusions:
- Brooklyn residents are at high risk for fluoroquinolone-resistant S. pneumoniae.
- Geographic and demographic factors, including increased healthcare and antibiotic use in western Brooklyn, may contribute to resistance.
- Vigilant regional surveillance is essential to monitor and combat emerging antibiotic resistance.