Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Isolates from Pediatric Patients in Singapore

Abstract

One hundred eighty Streptococcus pneumoniae strains isolated from children at a pediatric hospital in Singapore from 1997 to 1999 were serotyped and their antimicrobial susceptibility patterns were determined. Sixty-three percent of the isolates were resistant to penicillin. Significantly large numbers of the strains investigated were resistant to trimethoprim-sulfamethoxazole (87.8%), tetracycline (71.7%), erythromycin (67.8%), and chloramphenicol (40%). Penicillin and multidrug resistance was mostly associated with the frequently isolated S. pneumoniae isolates of serotypes (serotypes 19F, 23F, 6B, and 14). Isolates of serotype 19F, the serotype most commonly encountered in Singapore (41.1%), had the highest prevalence of penicillin (78.4%) and multidrug resistance (94.6%). Most of the invasive S. pneumoniae isolates (8 of 17; 47.1%) were of serotype 14.

Emergence in Vietnam of Streptococcus pneumoniae Resistant to Multiple Antimicrobial Agents as a Result of Dissemination of the Multiresistant Spain 23F -1 Clone

“…In the years 1999 to 2002, more than half of the isolates were penicillin nonsusceptible and one-quarter of the isolates were fully penicillin resistant and multiresistant. These rates are comparable to those obtained in studies in other Asian countries, including South Korea (2,13,16,19,29,30,31,32), Hong Kong (10,11,12,18), Taiwan (7,8,9,27), Singapore (15,28,30), Thailand (30), and Japan (30,36), but are considerably higher than those obtained in studies in other countries in this region such as China (21,35), Malaysia (25), and the Philippines (1). In a recent multicenter study of 996 clinical isolates from 11 Asian countries, including 176 isolates from blood or CSF, 18.3% showed intermediate susceptibility and 22.7% were fully resistant (30).…”

Antimicrobial resistance and serotyping of Streptococcus pneumoniae isolated from pediatric patients in Belo Horizonte, MG, Brazil

“…Our data suggest that, like in other countries, also in Brazil there is also a tendency for an increase in the rate of resistance to penicillin among S. pneumoniae isolated. In addition, the level of resistance to penicillin detected in the present survey seems to be much lower than in industrialized countries, such as France, Spain, and United States (54.0 to 65.0%) (3,16), South Korea (79.7%), Taiwan (70.0%), Japan (65.3%) and Singapore (63.3%) (9,14,15). In this survey, isolates exhibited predominantly intermediate resistance to penicillin with MICs between 0.1 and 1.0 µg/mL.…”

“…In our study, most of the penicillin-resistant isolates were also trimethoprimsulfamethoxazole resistant. High prevalence of resistance to trimethoprim-sulfamethoxazole is seen in Latin America, Asia, Europe and United States and may reflect the worldwide use of this drug association (13,14). A similar fact may be occuring with tetracycline since it is the second most commonly prescribed drug after penicillin worldwide (11).…”

Molecular analysis of Streptococcus pneumoniae clones causing invasive disease in children in Singapore

“…Existing data regarding the epidemiology of S. pneumoniae in Singapore have focussed on disease presentation (Low et al, 2007) or antibiotic resistance (Song et al, 2004a, b). Two previous studies have investigated serotype distribution among Singaporean childhood IPD isolates from 1997-1999 (n5180) and 1997-2004 (n5147) (Chong et al, 2008;Soh et al, 2000).…”

“…Existing data regarding the epidemiology of S. pneumoniae in Singapore have focussed on disease presentation (Low et al, 2007) or antibiotic resistance (Song et al, 2004a, b). Two previous studies have investigated serotype distribution among Singaporean childhood IPD isolates from 1997-1999 (n5180) and 1997-2004 (n5147) (Chong et al, 2008;Soh et al, 2000).Baseline data regarding the serotype prevalence of IPD are essential to inform policy around the use of pneumococcal conjugate vaccines (PCVs) in Singapore. PCV7 has been available on a demand basis in Singapore since October 2005 but was only incorporated into the national childhood vaccination schedule in November 2009 (Vasoo et al, 2010).…”