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The antimicrobial resistance profile of Streptococcus pneumoniae

R R Reinert1

  • 1International Scientific & Clinical Affairs, Vaccines, Wyeth Pharmaceuticals, La Défense, Paris, France. ReinerR@wyeth.com

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|April 16, 2009
PubMed

Insights

Antibacterial resistance in Streptococcus pneumoniae is rising globally, with 40% of strains showing multidrug resistance. Understanding resistance mechanisms and vaccine impacts is crucial for combating this trend.

Area of Science:

  • Microbiology
  • Epidemiology
  • Molecular Biology

Background:

  • Increasing global antibacterial resistance in Streptococcus pneumoniae, particularly to beta-lactams and macrolides.
  • Understanding resistance determinants and evolution is key to addressing this public health challenge.
  • The Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin (PROTEKT) study provides insights into resistance patterns.

Purpose of the Study:

  • To investigate the molecular mechanisms and epidemiological trends of antibiotic resistance in Streptococcus pneumoniae.
  • To analyze the impact of antibiotic use and vaccination programs on pneumococcal resistance and disease prevalence.

Main Methods:

  • Analysis of data from the PROTEKT study on pneumococcal isolates.
  • Identification of molecular determinants of resistance, including alterations in penicillin-binding proteins (PBPs) and specific resistance genes (erm(B), mef(A), mef(E)).
  • Evaluation of epidemiological data related to antibiotic resistance and vaccine impact, including serotype replacement.

Main Results:

  • Approximately 40% of pneumococci exhibit multidrug-resistant phenotypes, with significant international variation.
  • Beta-lactam resistance is associated with alterations in six specific penicillin-binding proteins.
  • Macrolide resistance is mediated by the erm(B) gene or the mef(A)/mef(E) genes, often found in serotype 14 strains.
  • Pneumococcal conjugate vaccine (PCV7) introduction led to decreased disease from targeted serotypes but increased prevalence of non-PCV7 serotypes (e.g., 19A).

Conclusions:

  • Molecular mechanisms like PBP alterations and specific resistance genes drive antibiotic resistance in Streptococcus pneumoniae.
  • Vaccination strategies influence pneumococcal epidemiology, potentially leading to serotype replacement and the emergence of resistant strains.
  • Continued surveillance and research are essential to manage evolving antibacterial resistance and vaccine-induced epidemiological shifts.

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