Serotype distribution and antimicrobial resistance of pediatric Streptococcus pneumoniae isolated from inpatients and outpatients at Beijing Children's Hospital

Lyu, Shuang; Shi, Wei; Dong, Fang; Xu, Bao Ping; Liu, Gang; Wang, Quan; Yao, Kai Hu; Yang, Yong Hong

doi:10.1016/j.bjid.2024.103734

The Brazilian Journal of Infectious Diseases

2024

DOI: 10.1016/j.bjid.2024.103734

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Serotype distribution and antimicrobial resistance of pediatric Streptococcus pneumoniae isolated from inpatients and outpatients at Beijing Children's Hospital

Shuang Lyu,

Wei Shi,

Fang Dong

et al.

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2024

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Cited by 3 publications

References 34 publications

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Estimation of in Vivo Performance of Sulfamethoxazole and Trimethoprim From Oral Suspensions Using in Vitro Release Data From a Mini Paddle Apparatus

RUIZ-SEGURA,

RIOS-RODRÍGUEZ,

REYES-RAMÍREZ

et al. 2024

Int J App Pharm

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Objective: To estimate plasma concentrations-time profiles of sulfamethoxazole (SMZ) and trimethoprim (TMP) from oral pediatric suspensions through in vitro data generated with a mini paddle apparatus and dissolution media of physiological relevance. Post-marketing evaluation of pediatric formulations is always necessary. Methods: Dissolution profiles of SMZ/TMP were obtained with a mini paddle apparatus at 100 rpm and 200 ml of 0.1 N HCl (pH 1.2), pH 4.5 acetate buffer, and pH 6.8 phosphate buffer. The reference and three multi-source pediatric formulations were tested. Drugs were quantified by a UV derivative method. Dissolution profiles were compared with model-independent and model-dependent methods. Plasma levels were estimated with dissolution data and published in vivo information. Percent of prediction error (%PE) for Cmax and AUC0-inf at each condition was calculated. Results: In all conditions, similar dissolution profiles were found excepting for TMP of C drug product at pH 1.2 (f2<50). With model-independent comparisons significant differences in in vitro release performance of SMZ and TMP from all multi-source formulations were found (*P<0.05). When comparing the hypothetical Cmax and AUC0-inf of both drugs with in vivo data PE<15% were found only with reference and one formulation at pH 1.2. Conclusion: The mini paddle apparatus and dissolution media of pH 1.2 were the best conditions to estimate in vivo plasma concentrations of SMZ and TMP from reference. These settings seem adequate to evaluate in vitro performance of multi-source formulations. It is necessary to carried out human studies with the used fixed-dose combination formulations to correlate in vitro/in vivo data.

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Estimation of in Vivo Performance of Sulfamethoxazole and Trimethoprim From Oral Suspensions Using in Vitro Release Data From a Mini Paddle Apparatus

RUIZ-SEGURA,

RIOS-RODRÍGUEZ,

REYES-RAMÍREZ

et al. 2024

Int J App Pharm

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Fourier transform infrared spectroscopy for Streptococcus pneumoniae capsular serotype classification in pediatric patients with invasive infections

Vasconcelos,

Rodrigues,

Krul

et al. 2024

Front. Microbiol.

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Invasive pneumococcal disease (IPD) is a major cause of morbidity and mortality worldwide, particularly in the pediatric population (children and infants), with high rates of hospitalization and death. This study aimed to create and validate a classifier for Streptococcus pneumoniae serotyping using Fourier-transform infrared (FT-IR) spectroscopy as a rapid alternative to the classical serotyping technique. In this study, a database comprising 76 clinical isolates, including 18 serotypes (predominantly serotypes 19A, 6C, and 3) of S. pneumoniae from pediatric patients with IPD, was tested at a tertiary pediatric hospital in southern Brazil during 2016–2023. All isolates were previously serotyped using the Quellung reaction, and 843 FT-IR spectra were obtained to create a classification model using artificial neural network (ANN) machine learning. After the creation of this classifier, internal validation was performed using 384 spectra as the training dataset and 459 as the testing dataset, resulting in a predictive accuracy of 98% for serotypes 19A, 6, 3, 14, 18C, 22F, 23A, 23B, 33F, 35B, and 9N. In this dataset, serotypes 10A/16F, 15ABC, and 7CF could not be differentiated and were, therefore, grouped as labels. FT-IR is a promising, rapid, and low-cost method for the phenotypic classification of S. pneumoniae capsular serotypes. This methodology has significant implications for clinical and epidemiological practice, improving patient management, monitoring infection trends, and developing new vaccines.

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Assessment of Antibiotic Resistance in Pediatric Infections: A Romanian Case Study on Pathogen Prevalence and Effective Treatments

Singer,

Văruț,

Popescu

et al. 2024

Antibiotics

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Antibiotic misuse in Romania has exacerbated the issue of antibiotic resistance, as patients often use antibiotics without proper medical consultation. This study aimed to assess the resistance of prevalent bacteria to different antibiotics. In this observational study conducted over six months, we analyzed 31 pediatric patients aged from 12 days to 13 years using the disk diffusion method. We identified 31 bacterial isolates, including 8 Gram-negative and 8 Gram-positive strains, with the most common being Pseudomonas aeruginosa, Escherichia coli, Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus, Streptococcus species, and Elizabethkingia meningoseptica. Our findings revealed that the most effective antibiotics were linezolid, ertapenem, and teicoplanin. In contrast, nearly all tested bacteria exhibited resistance to penicillin, followed by oxacillin and ampicillin. Resistance to cephalosporins varied with generation, showing higher resistance to lower-generation cephalosporins. The study highlights significant antibiotic resistance among common bacterial pathogens in Romanian pediatric patients, emphasizing the urgent need for controlled antibiotic use and alternative treatment strategies to combat this growing issue. Effective antibiotics such as linezolid and ertapenem offer potential solutions, whereas reliance on penicillin and lower-generation cephalosporins is increasingly futile.

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Serotype distribution and antimicrobial resistance of pediatric Streptococcus pneumoniae isolated from inpatients and outpatients at Beijing Children's Hospital

Cited by 3 publications

References 34 publications

Estimation of in Vivo Performance of Sulfamethoxazole and Trimethoprim From Oral Suspensions Using in Vitro Release Data From a Mini Paddle Apparatus

Estimation of in Vivo Performance of Sulfamethoxazole and Trimethoprim From Oral Suspensions Using in Vitro Release Data From a Mini Paddle Apparatus

Fourier transform infrared spectroscopy for Streptococcus pneumoniae capsular serotype classification in pediatric patients with invasive infections

Assessment of Antibiotic Resistance in Pediatric Infections: A Romanian Case Study on Pathogen Prevalence and Effective Treatments

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