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Published on: September 11, 2020
Emergence of antimicrobial-resistant serotype 19A Streptococcus pneumoniae--Massachusetts, 2001-2006
Abstract:
Streptococcus pneumoniae (pneumococcus) is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Treatment of the most serious type of pneumococcal infection, invasive pneumococcal disease (IPD), is complicated by antimicrobial resistance. Widespread introduction in 2000 of heptavalent pneumococcal conjugate vaccine (PCV7) against serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F resulted in a decline in antimicrobial-nonsusceptible IPD in the United States, including in Massachusetts. However, development of antimicrobial resistance in serotypes not covered by PCV7 is a growing concern. In Massachusetts during 2001-2006, IPD surveillance identified an increased number of cases in children caused by pneumococcal serotypes (most notably 19A) not covered by PCV7 and an associated increase in antimicrobial resistance among these isolates. This report examines these trends and clinical characteristics of Massachusetts patients with antimicrobial-nonsusceptible, non-PCV7-type IPD. The findings indicated that, despite increases in incidence of antimicrobial-nonsusceptible IPD, overall rates of IPD remained stable during 2001-2006. In addition, persons with IPD caused by antimicrobial-nonsusceptible S. pneumoniae had clinical outcomes comparable to persons with IPD caused by antimicrobial-susceptible serotypes. Although PCV7 is effective in preventing IPD, these results confirm that antimicrobial resistance among serotypes not covered by PCV7 remains a concern.
Insights
Antimicrobial resistance in Streptococcus pneumoniae (pneumococcus) serotypes not covered by the pneumococcal conjugate vaccine (PCV7) is a growing concern. Despite increased resistance in non-PCV7 types, overall invasive pneumococcal disease (IPD) rates remained stable.
Area of Science:
- Infectious Diseases
- Microbiology
- Vaccinology
Background:
- Streptococcus pneumoniae causes otitis, sinusitis, pneumonia, and meningitis globally.
- Antimicrobial resistance complicates treatment of invasive pneumococcal disease (IPD).
- The heptavalent pneumococcal conjugate vaccine (PCV7) reduced non-susceptible IPD post-2000.
Purpose of the Study:
- To examine trends and clinical characteristics of antimicrobial-nonsusceptible, non-PCV7 type IPD in Massachusetts.
- To assess the impact of PCV7 on antimicrobial resistance patterns in Streptococcus pneumoniae.
Main Methods:
- Surveillance of IPD cases in Massachusetts from 2001-2006.
- Analysis of antimicrobial resistance patterns in pneumococcal isolates.
- Evaluation of clinical outcomes for patients with IPD.
Main Results:
- Increased incidence of antimicrobial-nonsusceptible IPD caused by non-PCV7 serotypes (notably 19A) in children.
- Overall IPD rates remained stable despite rising antimicrobial resistance in specific serotypes.
- Clinical outcomes for IPD were comparable between antimicrobial-susceptible and nonsusceptible S. pneumoniae infections.
Conclusions:
- Antimicrobial resistance in non-PCV7 serotypes of Streptococcus pneumoniae is a significant concern.
- While PCV7 is effective, continued surveillance for emerging resistance is crucial.
- Further research into alternative or broader-spectrum vaccines may be warranted.
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