Streptococcus suis: A Possible Emerging Zoonotic Pathogen in Romania

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.