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Increasing antimicrobial resistance in clinical isolates of Streptococcus pneumoniae
Abstract:
The presence of antibiotic-resistant Streptococcus pneumoniae has become a major clinical problem in several parts of the world. However, there is a lack of data from Southeast Asia. We therefore initiated a study to determine the serogroups/serotypes and antimicrobial susceptibilities of clinical strains of S. pneumoniae isolated in our laboratory. In 1995, we isolated 144 strains of S. pneumoniae. Thirty-six (25.0%) strains were resistant to penicillin of which 19 (13.2%) were highly resistant (minimal inhibitory concentration > 1.0 microgram/ml). Thirty-eight (26.4%) strains were resistant to erythromycin, 75 (52.1%) were resistant to tetracycline, 48 (33.3%) were resistant to sulfamethoxazole-trimethoprim and 29 (20.1%) were resistant to chloramphenicol. Twenty of the penicillin-resistant strains also had diminished susceptibility to ceftriaxone. Strains resistant to penicillin belonged to serogroups/serotypes 6 (n = 1), 9 (n = 1), 23 (n = 4), 14 (n = 6) and 19 (n = 20). Children under 5 years of age were more likely than older children and adults to have isolates resistant to penicillin (52.9% versus 16.2%, P = 0.00002). Penicillin-resistant strains were more likely than penicillin-susceptible strains to be multidrug-resistant (86.1% versus 7.4%, P < 0.000005). We concluded that there is a high prevalence of penicillin-resistant pneumococci in our isolates especially among very young children. Most penicillin-resistant strains belong to serogroup 19 and are also resistant to multiple drugs.
Insights
Antibiotic-resistant Streptococcus pneumoniae is a growing concern. This study found high rates of penicillin resistance in Southeast Asia, particularly in young children, with many strains also resistant to multiple drugs.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Antibiotic resistance in Streptococcus pneumoniae is a significant global health issue.
- Data on antimicrobial resistance patterns in Southeast Asia are limited.
- Streptococcus pneumoniae causes serious infections like pneumonia and meningitis.
Purpose of the Study:
- To determine the serogroups/serotypes and antimicrobial susceptibilities of clinical Streptococcus pneumoniae strains in Southeast Asia.
- To assess the prevalence of antibiotic resistance in this region.
- To identify risk factors and associated resistance patterns.
Main Methods:
- Isolation and identification of 144 clinical strains of Streptococcus pneumoniae in 1995.
- Antimicrobial susceptibility testing using standard methods.
- Serotyping of penicillin-resistant isolates.
- Analysis of resistance patterns in relation to patient age.
Main Results:
- High prevalence of penicillin resistance (25.0%), with 13.2% being highly resistant.
- Significant resistance to other antibiotics: erythromycin (26.4%), tetracycline (52.1%), sulfamethoxazole-trimethoprim (33.3%), and chloramphenicol (20.1%).
- Penicillin-resistant strains were more common in children under 5 and frequently exhibited multidrug resistance (86.1%).
- Penicillin-resistant isolates were predominantly from serogroup 19.
Conclusions:
- There is a high prevalence of penicillin-resistant Streptococcus pneumoniae in the studied Southeast Asian population.
- Young children are disproportionately affected by penicillin-resistant pneumococcal infections.
- Penicillin-resistant strains are often multidrug-resistant, complicating treatment options.