Emergence of antimicrobial-resistant serotype 19A Streptococcus pneumoniae--Massachusetts, 2001-2006

    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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