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Intracranial Subarachnoidal Route of Infection for Investigating Roles of Streptococcus suis Biofilms in Meningitis in a Mouse Infection Model
Published on: July 1, 2018
Clinical characteristics, antimicrobial susceptibility, and predictors of mortality in Streptococcus suis infection:
Natchaya Pewton1, Kunakorn Assawawilaswong1, Phusanisa Wasinwasurat1
1Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand.
Purpose:
Streptococcus suis is an important zoonotic pathogen associated with severe disease and mortality. Reduced antimicrobial susceptibility has been increasingly reported. This study aimed to investigate the clinical characteristics, factors associated with mortality, and antimicrobial susceptibility of S. suis infections at a tertiary care hospital in Thailand.
Methods:
A retrospective cohort study was conducted among patients with S. suis infection between 2021 and 2025. Clinical characteristics, treatment outcomes, and antimicrobial susceptibility were collected. Multivariate logistic regression was used to identify factors associated with mortality.
Results:
A total of 87 patients (90 infection episodes) were included. Meningitis (37.8%) and endocarditis (26.7%) were the most common presentations. The in-hospital mortality rate was 11.1%, similar to the 14-day mortality rate (10.0%). Susceptibility testing showed that 34.48% of isolates were susceptible to penicillin, 82.35% to ceftriaxone, and 100% to vancomycin. Septic shock was independently associated with increased mortality (aOR 14.93; 95% CI 1.32-168.26; p = 0.029). Third-generation cephalosporin-based definitive regimens were associated with reduced mortality (aOR 0.10; 95% CI 0.01-0.81; p = 0.032).
Conclusion:
Most deaths occurred early and were associated with disease severity. Reduced susceptibility to penicillin and ceftriaxone was observed. Septic shock predicted mortality, whereas third-generation cephalosporin-based definitive therapy was associated with improved survival. Early recognition and appropriate antimicrobial therapy remain essential.
Insights
Streptococcus suis infections cause severe illness and death, with reduced susceptibility to common antibiotics. Early recognition and third-generation cephalosporin therapy improve survival, while septic shock predicts mortality.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Microbiology
Background:
- Streptococcus suis is a significant zoonotic pathogen causing severe human infections.
- Increasing antimicrobial resistance in S. suis poses a growing public health concern.
Purpose of the Study:
- To analyze clinical features of S. suis infections.
- To identify mortality predictors in S. suis patients.
- To assess antimicrobial susceptibility patterns of S. suis isolates.
Main Methods:
- Retrospective cohort study of 90 S. suis infection episodes (2021-2025).
- Data collection on clinical presentation, treatment, and outcomes.
- Multivariate logistic regression for mortality factor analysis.
Main Results:
- Meningitis and endocarditis were common. Overall mortality was 10-11.1%.
- Reduced susceptibility observed for penicillin (34.48%) and ceftriaxone (82.35%). Vancomycin showed 100% susceptibility.
- Septic shock independently predicted mortality (aOR 14.93); third-generation cephalosporins improved survival (aOR 0.10).
Conclusions:
- Early mortality is linked to disease severity.
- Observed reduced susceptibility to penicillin and ceftriaxone necessitates careful treatment selection.
- Prompt diagnosis and appropriate antimicrobial therapy, particularly third-generation cephalosporins, are crucial for better outcomes in S. suis infections.
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