Streptococcus pneumoniae: estudo das cepas isoladas de liquor

Abstract

Objective: To determine the frequency of capsular serotypes and the antimicrobial susceptibility of strains of Streptococcus pneumoniae, as well as to provide recommendations on the use of available vaccines and antimicrobial drugs. Methods:In this retrospective study, standard procedures were followed to identify, serotype, and determine bacterial susceptibility to penicillin, cefotaxime, and vancomycin. Pneumococcal strains were isolated from the Results: A total of 232 pneumococcal strains were isolated, including 126 (54.31%) strains from male patients.Patients had an age range of 0 to 62 years and were distributed into four age groups: 0 to 5, 6 to 17, 18 to 50, and above 50. From the 36 distinct serotypes identified, eight were more prevalent: 14, 6B, 18C, 5, 19F, 23F, 9V, and 6A. The oxacillin test identified 67 penicillin-resistant strains, out of which 47 were confirmed by the E test as having intermediate level of resistance. None of the strains exhibited high-level resistance. Conclusion:Pneumococcal resistance to penicillin has gradually increased over the last 10 years in Distrito Federal. Serotypes more frequently isolated in the 0 to 5 years age group were the same involved in penicillin-resistance, all of which are covered by the 7-valent vaccine.J Pediatr (Rio J). 2007;83(1):71-8: Pneumococcal meningitis, bacterial resistance to drugs, serotyping, pneumococcal vaccine.

Prevalence of pneumococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis

“…Despite the small size of the population studied, similarities with the results of other national [25][26][27][28][29][30][31][32] and Latin-American [25][26][27][28] surveys could be identifi ed. The profi le of the most frequently found serotypes in developing countries has been confi rmed, 14, 19F, 3, 7F, 6A/6B, 10A, 18C, 23F, 5, and 1, with an emphasis on the high prevalence of serotypes 1 and 5, commonly found in Latin America.…”

“…13 In our survey, serotype 3 is one of the most commonly found in patients with meningitis, and also found in children under the age of two years. The high frequency of serotypes 14, 6A, and 6B in invasive disease, especially in infants with meningitis, has already been reported in national [26][27][28][29][30][31][32] and Latin-American 26-28 studies. Although some serotypes have been associated with a particular disease, there is no exclusivity and different serotypes can cause different diseases.…”

“…31,32 Serotype 3, associated with severe forms of pneumonia in adults, 13,29 is also an important cause of invasive disease in newborns and infants, justifying its inclusion in a vaccine to protect children under the age of two years. 13 In our survey, serotype 3 is one of the most commonly found in patients with meningitis, and also found in children under the age of two years.…”

“…29 In this study, serotype 18C was detected in children under the age of fi ve years (8.5%) and serotype 19A, in only one patient over that age. Despite its low frequency in Brazil [25][26][27][28][29] and other LatinAmerican countries, serotype 19A is associated with penicillin resistance 13,23,[30][31][32] and is currently an important emerging serotype in the USA, after the release of the heptavalent conjugate vaccine for universal use. 7,13 In this study, the penicillin-resistance rate was 23.6% (17/72 strains) when all age brackets were considered, and 39.4% for ages up to two years (Table 2).…”

“…34 The documented resistance rates for both penicillin and ceftriaxone vary depending on factors, such as geographical location, sample size, time and duration of the assessment, patient's age, and nosology. Usually, resistance tends to predominate in children, 23,[31][32][33] especially in those with meningitis, 23,34 with increasing frequency 23,32,34 and intensity 23 over time in the communities not undergoing universal vaccination.…”