Multidrug-resistant Streptococcus pneumoniae causing invasive pneumococcal disease isolated from a paediatric patient

Abstract

The emergence of non-vaccine multidrug-resistant Streptococcus pneumoniae serotypes is on rise. This study was performed to investigate a highly resistant serotype 15A S. pneumoniae isolated from the blood specimen of a 20-month-old patient who died of her infection. The SS40_16 isolate was resistant to erythromycin, co-trimoxazole, tetracycline, and chloramphenicol, as well as to penicillin, ceftriaxone, and cefotaxime (using meningitis cut-off points, Clinical and Laboratory Standards Institute). The isolate belonged to sequence type 1591 (ST1591) and was related to CC81 clonal complex, suggesting the possibility of horizontal gene transfer. Scanning electron microscopy comparison between resistant and sensitive pneumococcal isolates also indicated similar phenotypic characteristics that confer high resistance. The emergence of highly resistant non-vaccine pneumococci is of great concern to public health and in the clinical setting. Pneumococcal surveillance programs represent a crucial tool, not only for determining the impact of pneumococcal conjugate vaccines, but also for monitoring the selective pressure of serotype replacement with regard to the treatment of invasive pneumococcal disease.

High proportion of drug-resistant isolates in adult community-acquired pneumonia from Northeast India

“…[ 24 ] This is in tune with the global trend of increasing resistance of S. pneumoniae to beta-lactams and macrolides. [ 19 25 26 27 28 ] Resistance to quinolones was found to be comparatively less; e.g., 21.1% of isolates were resistant to Levofloxacin [ Supplementary Table 1 ]. For moxifloxacin, it was even lesser at 15.8% perhaps attributable to the fact that this drug has an additional target, i.e., GyrA subunit of DNA gyrase compared to a single target (mutation-prone ParC subunit of the enzyme topoisomerase IV) for older fluoroquinolones (levofloxacin, ciprofloxacin).…”

Antibiotic Resistance and Molecular Biological Characteristics of Non-13-Valent-Pneumococcal Conjugate Vaccine Serogroup 15 Streptococcus pneumoniae Isolated From Children in China

“…Since the introduction of PCV13, many countries and regions that included PCV13 in their national immunization programs have reported increased infections from serogroup 15 S. pneumoniae, which is not covered by the PCV13 vaccine (Linden et al, 2015;Sheppard et al, 2016;Nakano et al, 2020). Serogroup 15 S. pneumoniae strains have caused outbreaks (Katherine et al, 2012) and deaths (Arushothy et al, 2020) The Pneumococcal Molecular Epidemiology Network (PMEN) 3 was established in 1997 for global surveillance of antibiotic-resistant S. pneumoniae and to standardize the nomenclature and classification of resistant clones. One 15A serotype was included among the 43 drug-resistant clones spread worldwide and published by the PMEN: Sweden 15A -25 (ST63).…”

“…Since the introduction of PCV13, many countries and regions that included PCV13 in their national immunization programs have reported increased infections from serogroup 15 S. pneumoniae , which is not covered by the PCV13 vaccine ( Linden et al, 2015 ; Sheppard et al, 2016 ; Nakano et al, 2020 ). Serogroup 15 S. pneumoniae strains have caused outbreaks ( Katherine et al, 2012 ) and deaths ( Arushothy et al, 2020 ) among children. China has not yet included PCV13 in the national immunization program, and the PCV13 vaccination rate among Chinese children is low.…”

The Molecular Approaches and Challenges of Streptococcus pneumoniae Serotyping for Epidemiological Surveillance in the Vaccine Era

“…An example is the evolution of serotype 19A, which becomes the primary circulating serotype not covered in PCV7 exhibiting multiple drug resistance ( Muñoz-Almagro et al 2008 ). Consequently, the infection likelihood from highly antibiotic-resistant NVT pneumococci is a new significant concern in societies and medical fraternities ( Arushothy et al 2020 ).…”