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Multidrug Resistance in Non-PCV13 Serotypes of Streptococcus pneumoniae in Northern Japan, 2014

Mitsuyo Kawaguchiya1, Noriko Urushibara1, Nobumichi Kobayashi1

  • 1Department of Hygiene, Sapporo Medical University School of Medicine , Sapporo, Japan .

Microbial Drug Resistance (Larchmont, N.Y.)
|June 4, 2016
PubMed

Insights

Nonvaccine serotypes of Streptococcus pneumoniae are increasing in Japan following PCV13 immunization. High rates of antibiotic resistance, including penicillin nonsusceptibility, were found in clinical isolates from children, with some strains showing multidrug resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Routine pneumococcal conjugate vaccine (PCV13) implementation in Japan has coincided with an increase in nonvaccine serotypes (NVTs) of Streptococcus pneumoniae.
  • These NVTs are increasingly detected in clinical isolates, necessitating surveillance of their antimicrobial resistance patterns.

Purpose of the Study:

  • To investigate the antibiotic susceptibility profiles of NVTs of Streptococcus pneumoniae isolated from children in northern Japan.
  • To identify the prevalence of penicillin nonsusceptibility (PNSP) and multidrug resistance (MDR) among these NVT isolates.

Main Methods:

  • Antimicrobial susceptibility testing against 18 antibiotics was performed on 231 NVT Streptococcus pneumoniae isolates collected from children under 16 years old.
  • Molecular methods, including sequencing type (ST) determination and analysis of resistance genes and penicillin-binding protein (PBP) alterations, were used for PNSP isolates.

Main Results:

  • High resistance rates were observed for macrolides (>90.9%), tetracycline (91.3%), and clindamycin (75.3%).
  • Penicillin nonsusceptibility (PNSP) was detected in 42.9% of isolates, with high prevalence in serotypes 15A, 23A, 6C, and 35B.
  • Overall, 42.0% of isolates exhibited multidrug resistance (MDR), and the international clone Sweden15A-ST63 was identified.

Conclusions:

  • The study highlights the significant spread of PNSP among NVTs, particularly serotypes 15A, 23A, 6C, and 35B, in northern Japan.
  • The emergence of MDR strains, including the Sweden15A-ST63 clone, poses a growing public health concern and underscores the need for ongoing surveillance.
Keywords:
Japanmultidrug resistancenon-PCV13 serotypespenicillin binding proteinspenicillin nonsusceptible pneumococciserotype 15A

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