Genome Evolution to Penicillin Resistance in Serotype 3 Streptococcus pneumoniae by Capsular Switching

Chiba, Naoko; Murayama, Somay Yamagata; Morozumi, Miyuki; Iwata, Satoshi; Ubukata, Kimiko

doi:10.1128/aac.00478-17

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…36,37 Penicillin is the first-line antibiotic for treating S. pneumoniae infection. 38 According to the revised CLSI breakpoints for penicillin, the penicillin nonsensitivity rate of nonmeningitis strains was 27.8%, and the penicillin resistance rate of meningitis strains was 100%. The resistance rate of meropenem was 8.8%.…”

Section: Discussionmentioning

confidence: 99%

PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

Jiang¹,

Meng²,

Liu³

et al. 2021

IDR

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Introduction: To determine the phenotypes and genotypes of invasive Streptococcus pneumoniae (S. pneumoniae), 108 strains were isolated from paediatric patients with invasive pneumococcal diseases (IPDs) in Shenzhen from 2014 to 2018. Methods: Serotype profiles were defined by multiplex PCR of the capsule gene. Pneumococcal surface protein A (PspA) classification was performed through pspA gene sequencing. Antimicrobial resistance was examined by broth microdilution. Multilocus sequence typing (MLST) was determined based on next-generation sequencing data. Results: Eighty-one S. pneumoniae of 17 serotypes were finally collected. The coverage of the 13-conjugated polysaccharide vaccine (PCV13) was 88.9%. After the introduction of PCV13, the nonvaccine serotypes were added by serotypes 15b, 16F and 20. Vaccine serotype 3 increased by four serious cases. The pspA family 1 and pspA family 2 are predominant. The multiple drug resistance rate is 91.3%. None of the nonmeningitis isolates were resistant to penicillin, while 98.8% of all the isolates were resistant to erythromycin. Discussion: This work characterizes the molecular epidemiology of invasive S. pneumoniae in Shenzhen. Continued surveillance of serotype distribution and antimicrobial susceptibility is necessary to alert antibiotic-resistant nonvaccine serotypes and highly virulent serotypes.

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Section: Discussionmentioning

confidence: 99%

PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

Jiang¹,

Meng²,

Liu³

et al. 2021

IDR

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“…Capsular switching in S. pneumoniae can occur as a result of homologous recombination at a site outside the cps locus. Of note, pbp1a genes are located upstream and pbp2x genes are located downstream of the cps locus ( 46 – 48 ). Recombination including these 2 pbp genes, driven by antimicrobial pressure, can result in concomitant exchange of the cps locus.…”

Section: Discussionmentioning

confidence: 99%

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017

Ubukata¹,

Takata²,

Morozumi³

et al. 2018

Emerg. Infect. Dis.

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105

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To clarify year-to-year changes in capsular serotypes, resistance genotypes, and multilocus sequence types of Streptococcus pneumoniae, we compared isolates collected from patients with invasive pneumococcal disease before and after introductions of 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PVC13, respectively). From April 2010 through March 2017, we collected 2,856 isolates from children and adults throughout Japan. Proportions of PCV13 serotypes among children decreased from 89.0% in fiscal year 2010 to 12.1% in fiscal year 2016 and among adults from 74.1% to 36.2%. Although nonvaccine serotypes increased after introduction of PCV13, genotypic penicillin resistance decreased from 54.3% in 2010 to 11.2% in 2016 among children and from 32.4% to 15.5% among adults. However, genotypic penicillin resistance emerged in 9 nonvaccine serotypes, but not 15A and 35B. Multilocus sequence typing suggested that resistant strains among nonvaccine serotypes may have evolved from clonal complexes 156 and 81. A more broadly effective vaccine is needed.

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“…Serotype switching due to capsular gene mutation is another mechanism of disease. This has been demonstrated with invasive serotype 3 and penicillinresistant serotype 23F [12]. The second line of pneumococcal defense is the peptidoglycan cell wall.…”

Section: Discussionmentioning

confidence: 96%

Conquering the pneumococcal nemesis with oral antibiotics

Garris

Rushdy

Qaqa

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: Streptococcus pneumoniae endocarditis (SPE) occurs in <3% of all EI cases due to the evolution of penicillin and vaccination. However, immunocompromised and unvaccinated patients are still at grave risk. Case: A 58-year-old African American male who used alcohol and intravenous (IV) drugs presented with confusion, fever, and hemoptysis. He had coarse rhonchi with a grade 2/5 holosystolic apical murmur. CT chest showed diffuse bilateral infiltrates. Blood cultures were positive for pansensitive Streptococcus pneumoniae. Echocardiogram demonstrated large vegetations on the anterior and posterior leaflets of the mitral valve with flail leaflet and severe eccentric mitral regurgitation. Patient was started on IV ceftriaxone, but after 3 weeks of therapy, he wished to leave against medical advice. He was discharged on combination oral therapy with successful resolution of SPE on follow-up. Discussion: Invasive pneumococcus is highly virulent causing irreversible valvular destruction or death.IV beta-lactams are first-line treatment, but there are currently no guideline-recommended alternatives for oral therapy. Recent data suggest partial oral therapy may be noninferior to IV only therapy. Conclusion: Switching to oral combination antibiotics after at least 2 weeks of IV therapy is an acceptable alternative to treat SPE.

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Genome Evolution to Penicillin Resistance in Serotype 3 Streptococcus pneumoniae by Capsular Switching

Cited by 14 publications

References 16 publications

PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017

Conquering the pneumococcal nemesis with oral antibiotics

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