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Emergence of multiple-antibiotic-resistant Streptococcus pneumoniae in Hong Kong
1Institute of Pathology, Sai Ying Pun Polyclinic, Department of Health, Hong Kong.
Abstract:
Two hundred four strains of Streptococcus pneumoniae isolated in Hong Kong from January 1993 to May 1995 were analyzed for their antibiotic susceptibilities and epidemiological patterns. The ages of the patients from whom the strains were isolated from 1 month to 93 years (median, 53 years); the male-to-female ratio was 2.8, with a predominance of males in the pediatric group. Fifty-nine (28.9%) strains showed reduced penicillin susceptibility, including 40 (19.6%) with frank penicillin resistance (MIC > 1 microgram/ml). Tetracycline resistance alone was found in 28.4% of strains. Isolates with reduced penicillin susceptibility were more common in children than adults (40 versus 23.9%, P = 0.02), and penicillin resistance rates were significantly higher in hospitalized patients than in outpatients (39.5 versus 12.5%; p < 0.001). Penicillin resistance was significantly associated with resistance to ceftriaxone, erythromycin, and tetracycline (P < 0.01) but not with ofloxacin or vancomycin (P = 0.5). Among eight different patterns of resistance to three or more antibiotics, the commonest one (14.2%) was multiple resistance to penicillin, chloramphenicol, ceftriaxone, erythromycin, and tetracycline. Emergence of multiple-antibiotic-resistant S. pneumoniae reflects changes in the pneumococcus itself and the general indiscriminate use of antibiotics in treatment of respiratory infections in Hong Kong.
Insights
Antibiotic resistance in Streptococcus pneumoniae is a growing concern. This study found significant penicillin resistance and multiple-drug resistant strains in Hong Kong, highlighting the need for judicious antibiotic use.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Streptococcus pneumoniae is a leading cause of bacterial infections worldwide.
- Antibiotic resistance in S. pneumoniae poses a significant public health threat.
- Understanding local resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To analyze antibiotic susceptibility and epidemiological patterns of Streptococcus pneumoniae strains isolated in Hong Kong.
- To identify the prevalence of penicillin resistance and multiple-drug resistance.
- To investigate associations between resistance and patient demographics or clinical settings.
Main Methods:
- Analysis of 204 S. pneumoniae isolates from Hong Kong (January 1993 - May 1995).
- Determination of antibiotic susceptibilities using minimum inhibitory concentration (MIC) breakpoints.
- Epidemiological data collection including patient age, sex, and hospitalization status.
Main Results:
- 28.9% of strains showed reduced penicillin susceptibility, with 19.6% exhibiting frank penicillin resistance (MIC > 1 µg/ml).
- Tetracycline resistance alone was observed in 28.4% of isolates.
- Penicillin resistance was more common in children and hospitalized patients, and significantly associated with resistance to ceftriaxone, erythromycin, and tetracycline.
Conclusions:
- The emergence of multiple-antibiotic-resistant S. pneumoniae strains in Hong Kong is a significant concern.
- Indiscriminate antibiotic use likely contributes to the observed resistance patterns.
- These findings underscore the need for antimicrobial stewardship and surveillance programs.