Susceptibility of Streptococcus pneumoniae to penicillin in the state of Minas Gerais, Brazil from 1997-2004

Abstract

We monitored the susceptibility to penicillin of invasive strains of Streptococcus pneumoniae in two reference laboratories; 502 positive cultures from patients with an active invasive infectious process were analyzed. Streptococcus pneumoniae was identified through conventional procedures, and the oxacillin disc diffusion method was used to check for penicillin susceptibility. Statistical analysis included calculations of the frequency distribution, with 95% confidence intervals (CI), as well as chi-square tests and chi-square for linear trend for temporal analysis of susceptibility. The bacterium was isolated from patients less than a year old (40.7% of the isolates), from infants (55.9%), and from individuals less than 15 years old (64.4%). The majority (88.2%, 95% CI = 85.5%-91.1%) of the 502 isolates were susceptible to penicillin. There was no significant temporal trend of elevation of resistance rate during the study period (p=0.56). We conclude that resistance of S. pneumoniae to penicillin is not yet an important clinical-epidemiological concern in the State of Minas Gerais. To provide necessary support for the adoption of therapeutic and prophylactic measures, epidemiological surveillance should be implemented at a national level to monitor the profile of susceptibility/resistance of S. pneumoniae to penicillin and other antimicrobials.

Susceptibility profiles and correlation with pneumococcal serotypes soon after implementation of the 10-valent pneumococcal conjugate vaccine in Brazil

“…20 Data from Brazil are still scarce and fragmented. Some studies have shown low 21,22 or no 23 rates of non-susceptibility to penicillin, whereas others have indicated rates around 20%; 24-25 serotypes 14, 23F, 6B, and 19F have been most commonly associated with this resistance in brazilian studies. 24,25 Full resistance (MIC >4.0 mg/ml) to penicillin was not found among the isolates included in this study.…”

Novos pontos de corte de sensibilidade nas taxas de resistência antimicrobiana de cepas invasivas de pneumococo

“…17 When this study was enlarged, including samples collected up to 1999 from children up to 6 years old, the total resistance rate was 20.7%, 13 a rate similar to the 20% value found in other local studies carried out in Brazil. 25,26 In the state of Minas Gerais, local studies have revealed rates of 11.8% of oxacillin-resistant strains 27 and 15.5% of penicillin-resistant pneumococcal invasive strains according to the traditional criteria. 28 According to the traditional criteria, the classification as resistant is clinically important in cases of acute otitis media and meningitis, but it is not relevant in cases of pneumonia.…”

Perfil clínico, epidemiológico e etiológico de pacientes com pneumonia adquirida na comunidade internados em um hospital geral da microrregião de Sumaré, SP

“…Little is known about the microbiological patterns at the local and regional levels or about the patterns of CAP severity in adults in Brazil. (5,6) Treatment protocols and case management protocols are often based on investigations of the disease in countries in the northern hemisphere. It should be borne in mind that the worldwide multicenter antimicrobial surveillance program, known as SENTRY, and the Latin American Sistema Regional de Vacunas (Regional Vaccination System) II program have been a reference for guiding therapy in Brazil.…”