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Antimicrobial resistance and type distribution of Streptococcus pneumoniae isolates causing systemic infections in
R R Reinert1, A Queck, A Kaufhold
1Institute of Medical Microbiology, Technical University, Aachen, Germany.
Abstract:
A prospective study of pneumococcal infections was performed in cooperation with 40 clinical microbiology laboratories in Germany. Minimal inhibitory concentration (MIC) values for 844 strains of Streptococcus pneumoniae, isolated from patients with systemic infections, were determined in tests with penicillin, tetracycline, erythromycin, chloramphenicol, cefotaxime, and clindamycin by a standard broth microdilution method; 1.8% of pneumococcal isolates exhibited reduced susceptibility to penicillin (MIC, > or = 0.1 micrograms/mL). The Etest, which was used to confirm the level of resistance to penicillin, proved to be a reliable and easily performed method for determination of MICs. The rates of resistance to clindamycin, erythromycin, tetracycline, and chloramphenicol were 1.4%, 3.2%, 11.0%, and 1.9%, respectively. Resistance to cefotaxime was not observed. Typing of a randomly selected subgroup of all strains (n = 115) showed types 1 (9.6%), 14 (8.7%), 3 (7.8%), and 23F (7.8%) to be the most prevalent types in Germany. At least 86.1% of these pneumococcal strains belonged to capsular types included in the 23-valent vaccine.
Insights
This study on Streptococcus pneumoniae in Germany found low resistance rates to most tested antibiotics, with cefotaxime showing no resistance. Most strains belonged to types covered by the 23-valent pneumococcal vaccine.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Bacteriology
Background:
- Pneumococcal infections pose a significant global health burden.
- Antimicrobial resistance in Streptococcus pneumoniae is a growing concern.
- Understanding local resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To determine the antimicrobial susceptibility of Streptococcus pneumoniae strains isolated from systemic infections in Germany.
- To assess the prevalence of specific pneumococcal serotypes in Germany.
- To evaluate the suitability of the 23-valent pneumococcal vaccine for the German population.
Main Methods:
- Prospective study involving 40 clinical microbiology laboratories in Germany.
- Minimal inhibitory concentration (MIC) determination for 844 Streptococcus pneumoniae strains using standard broth microdilution.
- Testing against penicillin, tetracycline, erythromycin, chloramphenicol, cefotaxime, and clindamycin.
- Serotyping of 115 randomly selected strains.
Main Results:
- 1.8% of isolates showed reduced susceptibility to penicillin (MIC >= 0.1 µg/mL).
- Resistance rates were 1.4% for clindamycin, 3.2% for erythromycin, 11.0% for tetracycline, and 1.9% for chloramphenicol.
- No resistance was observed for cefotaxime.
- Prevalent serotypes in Germany included type 1 (9.6%), 14 (8.7%), 3 (7.8%), and 23F (7.8%).
- 86.1% of strains belonged to serotypes included in the 23-valent vaccine.
Conclusions:
- Overall low rates of antimicrobial resistance were observed in Streptococcus pneumoniae in Germany.
- Cefotaxime demonstrated excellent activity against the studied strains.
- The majority of prevalent pneumococcal serotypes in Germany are covered by the 23-valent vaccine, suggesting its continued relevance.