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Fatal infection caused by a multiply resistant type 3 pneumococcus
J B Lawrenson1, K P Klugman, J I Eidelman
1Department of Internal Medicine, J.G. Strijdom Hospital, Johannesburg, South Africa.
Abstract:
The most virulent pneumococcal serotype (type 3) has not to date been associated with multiple antimicrobial resistance. We report an unusual gastrointestinal presentation of fatal septicemia caused by a multiply resistant type 3 pneumococcus in a setting of increasing prevalence of multiple resistance, including resistance to erythromycin, clindamycin, and tetracycline.
Insights
Type 3 pneumococcus, typically not drug-resistant, caused fatal septicemia in an unusual gastrointestinal case. This highlights emerging antimicrobial resistance in virulent bacterial strains.
Area of Science:
- Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae serotype 3 is known for high virulence.
- Multiple antimicrobial resistance is an increasing global health concern.
- Historically, type 3 pneumococcus has not been linked to multidrug resistance.
Observation:
- An unusual gastrointestinal presentation of pneumococcal septicemia was observed.
- The causative agent was identified as Streptococcus pneumoniae type 3.
- The isolate exhibited multiple antimicrobial resistance.
Findings:
- This case represents the first reported instance of fatal septicemia caused by a multidrug-resistant type 3 pneumococcus.
- The resistant strain showed resistance to erythromycin, clindamycin, and tetracycline.
- The infection presented atypically via the gastrointestinal tract.
Implications:
- This finding necessitates enhanced surveillance for multidrug-resistant pneumococcal infections, particularly type 3.
- The emergence of resistance in highly virulent strains poses a significant threat to public health.
- Clinical and diagnostic approaches may need re-evaluation for severe pneumococcal disease presentations.