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Published on: September 11, 2020
Resistance of Streptococcus pneumoniae isolated from Lebanese patients between 2005 and 2009
Ziad Daoud1, Mariam Kourani, Rawan Saab
1Department of Biomedical Sciences, Faculty of Medicine & Medical Sciences, University of Balamand, POBox: 100- Tripoli, Lebanon. ziad.daoud@balamand.edu.lb
Introduction:
Streptococcus pneumoniae is an important organism in view of its prevalence and ability to cause serious infections; its resistance to antimicrobial agents is increasing worldwide. The purpose of this study was to evaluate the patterns of resistance of S. pneumoniae to penicillin, macrolides and various other antibiotics in strains isolated from Lebanese patients.
Methods:
121 strains isolated between January 2005 and January 2009 from two university hospitals in Beirut were identified and tested for MIC determination using the E-test method. The presence of erm(B) and mef(A/E) genes was investigated using PCR.
Results:
The majority of the strains (73.5%) were isolated from respiratory tract infections, 50.4% were isolated in winter, 15.7% were invasive strains, 61.9% came from male patients, and 68.5% from adults. Out of 121 isolates, 58 were susceptible to penicillin, 61 were intermediate, and 2 were fully resistant to this antibiotic. Amoxicillin-clavunanic acid and cefpodoxime showed 100% activity on all tested isolates. In general, the MICs90 appear to fluctuate within the same range over the four years. The erm(B) gene was detected in 85.3% of the isolates, mef(A/E) in 19.5% whereas erm(A) was not detected in any of the macrolide resistant strains.
Discussion:
The results of this study have important impact on the empirical antibiotic prescriptions; the increasing prevalence of resistance jeopardises the treatment choices posing a serious threat. Further surveillance and epidemiological serotyping are needed to monitor the local and regional resistance patterns and to track the spread route of resistance.
Insights
Antibiotic resistance in Streptococcus pneumoniae is rising globally. This study found significant penicillin resistance in Lebanese strains, highlighting the need for ongoing surveillance and updated treatment guidelines to combat serious infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae is a prevalent pathogen causing severe infections.
- Increasing antimicrobial resistance worldwide poses a significant public health threat.
- Understanding local resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To evaluate antimicrobial resistance patterns of S. pneumoniae in Lebanon.
- To assess resistance to penicillin, macrolides, and other antibiotics.
- To identify resistance genes in clinical isolates.
Main Methods:
- Analysis of 121 S. pneumoniae strains isolated between 2005-2009 in Beirut.
- Minimum Inhibitory Concentration (MIC) determination using E-test.
- Polymerase Chain Reaction (PCR) to detect erm(B) and mef(A/E) genes.
Main Results:
- Most strains (73.5%) were from respiratory tract infections.
- Penicillin showed intermediate resistance in 50.4% and full resistance in 1.6% of isolates.
- Amoxicillin-clavulanic acid and cefpodoxime demonstrated 100% activity; erm(B) was prevalent in macrolide-resistant strains (85.3%).
Conclusions:
- Rising S. pneumoniae resistance impacts empirical antibiotic prescribing.
- Treatment choices are jeopardized, posing a serious threat.
- Continued surveillance and epidemiological studies are essential to monitor and control resistance spread.
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