Spread of Drug‐ResistantStreptococcus pneumoniaein Asian Countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

Abstract

Antimicrobial susceptibility of 996 isolates of Streptococcus pneumoniae from clinical specimens was investigated in 11 Asian countries from September 1996 to June 1997. Korea had the greatest frequency of nonsusceptible strains to penicillin with 79.7%, followed by Japan (65.3%), Vietnam (60.8%), Thailand (57.9%), Sri Lanka (41.2%), Taiwan (38.7%), Singapore (23.1%), Indonesia (21.0%), China (9.8%), Malaysia (9.0%), and India (3.8%). Serotypes 23F and 19F were the most common. Pulsed-field gel electrophoresis (PFGE) of 154 isolates from Asian countries showed several major PFGE patterns. The serotype 23F Spanish clone shared the same PFGE pattern with strains from Korea, Japan, Singapore, Taiwan, Thailand, and Malaysia. Fingerprinting analysis of pbp1a, pbp2x, and pbp2b genes of 12 strains from six countries also showed identical fingerprints of penicillin-binding protein genes in most strains. These data suggest the possible introduction and spread of international epidemic clones into Asian countries and the increasing problems of pneumococcal drug resistance in Asian countries for the first time.

Increasing invasive disease due to penicillin resistant <i> S. pneumoniae </i> in India

“…A well-known and widespread study conducted in Asia by ANSORP [1][2][3] (Asian Network for Surveillance of Resistant Pathogens) reported the highest prevalence of penicillin resistance in isolates from Vietnam (71.4%), followed …”

“…Thereafter the proportion of PIRSP has been steadily increasing over the last decade. This includes 3.8% in 1996-97 among the clinical isolates [1] 12.8% among carriage isolates; [2] 7.8% in 2000 -2001 among the clinical pathogens [3] ; and 1.48% in 1993-97 among clinical isolates. [5] Nevertheless, in 1999, [6] a 4.6% (n = 25) which included eight CSF isolates with intermediate resistant to penicillin (0.125-1.0 µg/ml) was reported.…”

“…Notably, among the Asian countries, India had the lowest percentage of penicillin intermediate resistance to S. pneumoniae (PIRSP) and virtually no complete penicillin resistance in IPD isolates. [1][2][3] Here,…”

Caracterización molecular de aislamientos invasores de Streptococcus pneumoniae resistentes a la penicilina recuperados de pacientes adultos.

“…En 1990, Muñoz y col. (30) demostraron la dispersión del clon 1-España 23F a los Estados Unidos, el cual fue posteriormente identificado en diferentes regiones del mundo (4,16,21,31). Varios estudios en Suramérica han establecido una baja frecuencia en la recuperación de aislamientos de S. pneumoniae relacionados con el clon 1 en población infantil (32)(33)(34), los cuales contrastan con los obtenidos en México, donde los aislamientos relacionados con este clon tienen una prevalencia de 66% (9), similar a la obtenida en los países asiáticos donde la resistencia a la penicilina asociada con el clon 1 supera 50% (4).…”

Meeting the challenge: prevention of pneumococcal disease with conjugate vaccines

“…34,35 Subsequently, this phenomenon was reported in Australia in 1967 and in South Africa in 1977, where strains with both a high level of penicillin resistance and multiple antibiotic resistances were reported. Penicillin resistance spread rapidly throughout the world in the 1980s, mainly in South Africa, 36,37 Spain, 38 Hungary, 39 Czechoslovakia, 40,41 Asia, 42 the United States of America (USA), 43,44 Australia, 45 and other European countries. [46][47][48] In Latin American countries (i.e., Argentina, Brazil, Colombia, Chile, Mexico, and Uruguay), the SIRE-VA network in 1998 studied 1 649 sterile-site isolates from children younger than 5 years of age.…”