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Resistance patterns of streptococcus pneumoniae from carriers attending day-care centers in southwestern Greece
G A Syrogiannopoulos1, I N Grivea, N G Beratis
1Department of Pediatrics, University of Patras School of Medicine, General University Hospital, Greece.
Insights
Antibiotic resistance in Streptococcus pneumoniae is a growing concern. This study found over half of pneumococcal isolates from Greek children showed reduced susceptibility to common antibiotics, highlighting the need for global surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Streptococcus pneumoniae is a leading cause of bacterial infections in children.
- Antibiotic resistance in S. pneumoniae poses a significant global health threat.
- Day-care centers are potential hotspots for the transmission of resistant bacteria.
Purpose of the Study:
- To investigate the prevalence of antibiotic resistance in nasopharyngeal isolates of S. pneumoniae from children in Greece.
- To determine resistance patterns to both beta-lactam and non-beta-lactam antibiotics.
- To identify specific serogroups associated with antibiotic resistance.
Main Methods:
- Collection of 133 nasopharyngeal isolates of S. pneumoniae from children in southwestern Greece (1995-1996).
- Antimicrobial susceptibility testing against various antibiotics, including penicillin, cefotaxime, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, and erythromycin/clindamycin.
- Serotyping of resistant S. pneumoniae strains.
Main Results:
- 53% of isolates exhibited reduced susceptibility to one or more antibiotics.
- High resistance rates were observed for trimethoprim-sulfamethoxazole (43%), tetracycline (29%), and chloramphenicol (27%).
- Penicillin resistance was 12%, with 17% intermediate susceptibility. 87% of penicillin-resistant strains were serogroups 19, 21, and 23.
- 56% of resistant isolates were multiply resistant, with unique patterns observed in serogroups 6 and 23.
Conclusions:
- A high incidence of antibiotic-resistant S. pneumoniae was found in this Greek pediatric population.
- Divergent and unique resistance patterns underscore the evolving nature of pneumococcal resistance.
- Global surveillance is crucial to monitor the spread of resistant strains and inform therapeutic strategies.
Abstract:
The resistance to beta-lactam and non-beta-lactam antibiotics of 133 nasopharyngeal isolates of Streptococcus pneumoniae recovered from December 1995 to February 1996 from children attending seven day-care centers in southwestern Greece was studied. Reduced susceptibility to one or more anti-microbial agents was found in 70 isolates (53%), as follows: penicillin, 17% intermediate, 12% resistant; cefotaxime, 10.5% intermediate, 1.5% resistant; trimethoprim-sulfamethoxazole, 8% intermediate, 35% resistant; chloramphenicol, 27% resistant; tetracycline, 29% resistant; and erythromycin/clindamycin, 19% resistant. Eighty-seven percent of penicillin-intermediate or -resistant strains belonged to serogroups/serotypes 19, 21, and 23. Fifty-six percent of the antibiotic-resistant pneumococci were multiply resistant, including serogroup 6 strains that were penicillin-susceptible but resistant to all non-beta-lactam drugs tested, as well as serogroup 23 strains resistant to penicillin, chloramphenicol, tetracycline, and trimethoprim-sulfamethoxazole. The high incidence of antibiotic-resistant pneumococci and the divergent and unique resistance patterns found in this study underline the need for global surveillance of S. pneumoniae to document the evolution and spread of resistant strains and to guide therapy.