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Characterization of macrolide-resistant non-invasive pneumococci in the pre-vaccine era in Serbia

Suncica Popovic1, Mirjana Hadnadjev2, Ina Gajic1

  • 11 Institute of Microbiology and Immunology, Medical Faculty University of Belgrade , Belgrade, Republic of Serbia.

Acta Microbiologica Et Immunologica Hungarica
|July 17, 2018
PubMed

Insights

High co-resistance to macrolides and penicillin was found in pneumococcal isolates in Serbia. Most resistant strains belonged to serotypes included in conjugate vaccines, highlighting a significant public health concern.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Increased macrolide use drives antibiotic resistance in respiratory infections.
  • Pneumococcal vaccines are known to reduce antibiotic resistance.
  • Understanding resistance patterns is crucial for effective treatment and prevention.

Purpose of the Study:

  • To determine co-resistance to penicillin and other antibiotics in macrolide-resistant pneumococci.
  • To evaluate serotype distribution among resistant strains in Serbia's pre-vaccine era.
  • To assess the prevalence of multiresistance in macrolide-resistant pneumococcal isolates.

Main Methods:

  • Phenotypic characterization of macrolide resistance (MLS, M phenotypes).
  • Antimicrobial susceptibility testing for penicillin, erythromycin, clindamycin, tetracycline, and trimethoprim-sulfamethoxazole.
  • Serotyping of 157 macrolide-resistant Streptococcus pneumoniae isolates.

Main Results:

  • Approximately 80% of macrolide-resistant isolates exhibited MLS phenotype with high resistance to erythromycin and clindamycin.
  • 132 (84.1%) isolates were multiresistant, showing resistance to erythromycin, penicillin, tetracycline, and trimethoprim-sulfamethoxazole.
  • Four serotypes (19F, 14, 6B, 23F) constituted 77.7% of macrolide-resistant isolates, all included in current conjugate vaccines.

Conclusions:

  • High co-resistance to macrolides and penicillin is prevalent in non-invasive pneumococcal isolates.
  • The predominance of vaccine-included serotypes among resistant strains underscores a significant challenge.
  • Findings emphasize the need for ongoing surveillance of antibiotic resistance patterns in pneumococci.
Keywords:
macrolide resistancepneumococciserotypevaccine

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