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Advances in pneumococcal antibiotic resistance.

Jae-Hoon Song1

  • 1Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea . +82 234 100 320 +82 234 100 328 songjh@skku.edu.

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Antimicrobial resistance in Streptococcus pneumoniae is increasing, particularly macrolide resistance in Asia. Pneumococcal conjugate vaccines (PCV) may help reduce the spread of drug-resistant strains like serotype 19A.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Vaccinology

Background:

  • Antimicrobial resistance and serotypes in Streptococcus pneumoniae are evolving due to antibiotic use and pneumococcal conjugate vaccines (PCV).
  • Macrolide resistance has significantly increased globally, exceeding 70% in clinical isolates from Asian countries.
  • Changes in resistance breakpoints have decreased penicillin resistance but increased resistance to other beta-lactams like cefuroxime.

Purpose of the Study:

  • To analyze the evolving landscape of antimicrobial resistance and serotypes in Streptococcus pneumoniae.
  • To assess the impact of pneumococcal conjugate vaccines on drug-resistant strains.
  • To highlight the growing concern of multidrug resistance in invasive pneumococcal diseases, especially in Asia.

Main Methods:

  • Analysis of antimicrobial resistance patterns and serotype prevalence in Streptococcus pneumoniae isolates.
  • Review of trends in resistance breakpoints and vaccine impact.
  • Epidemiological assessment of invasive pneumococcal diseases.

Main Results:

  • Macrolide resistance is a major concern, with high prevalence in Asian countries.
  • Serotype 19A emerged as a significant cause of invasive pneumococcal disease post-PCV7, often linked to multidrug resistance.
  • Widespread use of PCV13 may decrease the spread of drug-resistant 19A pneumococci.

Conclusions:

  • Multidrug resistance in Streptococcus pneumoniae, particularly in Asian countries, poses a serious threat to treating invasive pneumococcal diseases.
  • Pneumococcal conjugate vaccines, especially PCV13, show potential in controlling the spread of drug-resistant serotypes.
  • Continued surveillance of antimicrobial resistance and serotype distribution is crucial for effective pneumococcal disease management.