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Streptococcus suis: A Possible Emerging Zoonotic Pathogen in Romania.

Serban Nicolae Benea1,2, Ruxandra Moroti1,2, Teodora Deaconu2

  • 1Department of Infectious Diseases, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

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|February 26, 2025
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Summary

Streptococcus suis, a pig bacterium, is an emerging zoonotic threat. This study highlights its presence in Romania, causing severe meningitis and endocarditis, with hearing loss as a common sequela.

Keywords:
EuropeStreptococcus suisataxiadeafnessmeningitispigs and porkprolonged coursesequelae

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Streptococcus suis is a significant pathogen in swine populations globally.
  • It is recognized as an emerging zoonotic agent, particularly in regions with high consumption of raw pork.
  • Limited data exists on Streptococcus suis invasive infections in Eastern Europe, including Romania.

Purpose of the Study:

  • To investigate the epidemiology and clinical characteristics of Streptococcus suis invasive infections in Romania.
  • To raise awareness among clinicians regarding this pathogen in non-endemic areas.
  • To analyze antimicrobial susceptibility patterns of isolated strains.

Main Methods:

  • Retrospective review of medical records from an infectious diseases tertiary hospital in Bucharest (2001-2024).
  • Inclusion of eight patients diagnosed with invasive Streptococcus suis infection.
  • Analysis of patient demographics, risk factors, clinical presentation, laboratory findings, and outcomes.

Main Results:

  • Eight patients (median age 53.3 years, 3:1 male:female ratio) were identified.
  • Risk factors included contact with pigs or handling fresh pork in three patients.
  • Meningitis was the primary diagnosis in seven patients, with one developing endocarditis; an additional endocarditis case was identified during hospitalization. Streptococcus suis was isolated from CSF (6 cases) and blood (2 cases).
  • All isolates were susceptible to beta-lactams but resistant to lincosamides and macrolides.
  • No deaths occurred, but 50% of patients experienced severe sequelae, primarily hearing loss.

Conclusions:

  • Streptococcus suis should be considered an etiological agent of meningitis and endocarditis in Romania, even in non-endemic settings.
  • Clinicians should maintain a high index of suspicion in patients with relevant risk factors.
  • Prompt diagnosis and appropriate antibiotic treatment are crucial to prevent severe sequelae.