Prevalence of pneumococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis

Alvares, Jackelline Rodrigues; Mantese, Orlando César; Paula, Alan de; Wolkers, Paula Carolina Bejo; Almeida, Viviene Vieira Prado; Almeida, Samanta Cristine Grassi; Guerra, Maria Luiza Leopoldo Silva; Brandileone, Maria Cristina de Cunto

doi:10.1590/s1413-86702011000100005

Cited by 5 publications

(7 citation statements)

References 17 publications

(50 reference statements)

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“…From 1988 to 1999, 31.8% (55/173) of the isolates presented nonsusceptibility to penicillin, with a mean MIC of 1 g/ml (range, 0.12 to 4 g/ml). From 2000 to 2011, 69.7% (99/142) of the isolates were PNSP, with an average MIC of 2 g/ml (range: 0.12 to 16 g/ml), supporting previous studies that have shown higher PNSP rates and MIC levels among isolates recovered in the 2000s compared to those obtained in the 1990s (7,9,10,12). Among PNSP isolates included in the present study, CC156 was largely represented, followed by CC66.…”

Section: Discussionsupporting

confidence: 85%

“…Antimicrobial resistance rates among pneumococcal isolates can vary according to the clinical condition, patient age, geographical region, and serotype of the pneumococcal strain. In this context, several studies performed with pneumococcal isolates from Brazil have suggested that serogroup 9 and serotype 14 are among the most important capsular types driving the emergence of PNSP in our region (6)(7)(8)(9)(10)(11)(12)(13). In the present study, nearly half of the serogroup 9 and 14 isolates were PNSP, confirming that nonsusceptibility to penicillin is very common among these serotypes in Brazil.…”

Section: Discussionsupporting

confidence: 83%

“…In Brazil, emergence of PNSP has been mainly attributed to the expansion of serogroup 9 and serotype 14 isolates, especially those belonging to successful and widespread clones described by the Pneumococcal Molecular Epidemiology Network (PMEN; http: //www.pneumogen.net/pmen/), such as Spain 9V -3 ST156 (6)(7)(8)(9)(10)(11)(12)(13). Moreover, a pneumococcal conjugate vaccine (10-valent scheme, PCV10) was gradually introduced in the Brazilian National Immunization Program for children under 1 year old in 2010 (14), necessitating a more focused and continuous surveillance in the region.…”

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confidence: 99%

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Streptococcus pneumoniae Serotypes 9 and 14 Circulating in Brazil over a 23-Year Period Prior to Introduction of the 10-Valent Pneumococcal Conjugate Vaccine: Role of International Clones in the Evolution of Antimicrobial Resistance and Description of a Novel Genotype

Pinto

Kegele

Dias

et al. 2016

Antimicrob Agents Chemother

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Antimicrobial-resistant pneumococcal strains have been detected worldwide since the 1960s. In Brazil, the first penicillin-nonsusceptible pneumococci (PNSP) were reported in the 1980s, and their emergence and dissemination have been mainly attributed to serogroup 9 and serotype 14 strains, especially those highly related to recognized international clones. In the present study, antimicrobial susceptibility testing and multilocus sequence typing were performed on 315 pneumococcal isolates belonging to serogroup 9 (n = 99) or serotype 14 (n = 216), recovered from patients or asymptomatic carriers between 1988 and 2011 in Brazil, in order to trace changes in antimicrobial resistance and genotypes prior to the full introduction of the pneumococcal conjugate vaccine in the country. Over the 23-year study period, the PNSP levels increased, and four clonal complexes (CC156, CC66, CC15, and CC5401) have played important roles in the evolution and dissemination of pneumococcal isolates belonging to serogroup 9 and serotype 14, as well as in the emergence of antimicrobial resistance, in the pre-pneumococcal-vaccination era. The earliest PNSP strains detected in this study belonged to serotype 9N/ST66 and were single locus variants of the international clone Tennessee-18 ST67 (CC66). The first serotype 14 PNSP isolates were identified in 1990 and were related to the England-9 ST9 (CC15) clone. Serotype 14 PNSP variants of the Spain-3 ST156 clone with elevated penicillin MICs and nonsusceptibility to other beta-lactams were detected in 1995 and showed an increasing trend over the years. The results also indicated that introduction of ST156 in our region was preceded by the emergence of trimethoprim-sulfamethoxazole resistance and by the dissemination of ST162. In addition to the presence of successful international clones, a novel regional serotype 14 genotype (CC5401) has emerged in 1996.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 83%

mentioning

confidence: 99%

See 1 more Smart Citation

Streptococcus pneumoniae Serotypes 9 and 14 Circulating in Brazil over a 23-Year Period Prior to Introduction of the 10-Valent Pneumococcal Conjugate Vaccine: Role of International Clones in the Evolution of Antimicrobial Resistance and Description of a Novel Genotype

Pinto

Kegele

Dias

et al. 2016

Antimicrob Agents Chemother

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“…In a study carried out in Brazil on the meningitis patients varying one month old to 85 y old, serotypes of 5, 23F, 18C, 10A, 6B, 6A, 7F, 3, 19F, 14, and 34 were found [16].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Heptavalent Vaccine- related Pneumococcal Serotypes in Nasopharyngeal carrier in children under five years old in Shahrekord, Iran by Multiplex-PCR during 2010- 2011

Khoshdel

Rastabi

Doosti

et al. 2014

JCDR

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“…Significant increases in the penicillin-resistance rates of invasive pneumococcal strains have been reported in Brazil. 16 Pneumococcal infections, which may be seen in every age group, may result in severe sequel or death due to treatment failures caused by bacterial resistance, especially if they occur in life-threatening locations. Thus, knowledge on pneumococcal resistance patterns enables initiation of an appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital

Pehlivanoğlu¹

2014

Jmid

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Objective: There have been prominent changes in evaluation of resistance patterns of pneumococci and breakpoint values in recent years. We aimed to investigate the penicillin sensitivity of pneumococcal strains isolated from the cerebrospinal fluid specimens between the years 1997-2011 in our hospital and determine the MIC values under the light of these changes. Methods: Identification of pneumococci was made with conventional methods in patients with meningitis. MIC values for penicillin G were investigated by E test method in all strains. MIC values of pneumococci strains were evaluated according to values determined by CLSI for meningitis isolates in 2008. Results: A total of 57 strains were investigated in this study. The MIC range for penicillin was 0.016-0.75 μg/ml in S. pneumoniae strains. Seventy five percent of the strains were sensitive and eight strains (14%) had resistance. MIC50 value was sensitive, and a MIC90 value was resistant. The first resistant strain was detected in 2000, and three strains were resistant in the last year. When examined over the years increased resistance was 5.3% in the first five-year period seems to be 28.6% in the last five-year period. Conclusions: Knowledge on penicillin resistance patterns and surveillance is very important in the empirical treatment in pneumococcal meningitis.

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Prevalence of pneumococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis

Cited by 5 publications

References 17 publications

Streptococcus pneumoniae Serotypes 9 and 14 Circulating in Brazil over a 23-Year Period Prior to Introduction of the 10-Valent Pneumococcal Conjugate Vaccine: Role of International Clones in the Evolution of Antimicrobial Resistance and Description of a Novel Genotype

Streptococcus pneumoniae Serotypes 9 and 14 Circulating in Brazil over a 23-Year Period Prior to Introduction of the 10-Valent Pneumococcal Conjugate Vaccine: Role of International Clones in the Evolution of Antimicrobial Resistance and Description of a Novel Genotype

Prevalence of Heptavalent Vaccine- related Pneumococcal Serotypes in Nasopharyngeal carrier in children under five years old in Shahrekord, Iran by Multiplex-PCR during 2010- 2011

Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital

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