β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil

Abstract

Background Here, we report a laboratory-based study of Streptococcus pneumoniae recovered from patients with meningitis in Rio de Janeiro State, Brazil. Methods The aim of this study was to determine the evolution of β-lactam resistance, antimicrobial susceptibility pattern, serotypes, and genetic diversity of S. pneumoniae, isolated from meningitis patients between 2000 and 2008. Results A total of 264 S. pneumoniae recovered from patients between 2000 and 2008 were included. Susceptibility testing (E-test) of S. pneumoniae showed resistance to penicillin, ceftriaxone, oxacillin, cotrimoxazole, tetracycline, ofloxacin, erythromycin, chloramphenicol, and rifampicin. Penicillin resistance (PEN-R, minimal inhibitory concentration [MIC] ≥0.12 μg/mL) increased from 8% of isolates in 2000–2002, to 12% in 2003–2005, and to 20% in 2006–2008. Ceftriaxone resistance (MIC ≥1.0 μg/mL) was detected among some PEN-R isolates (13%) from 2004 onward. Within the PEN-R isolates, serotypes that are included in 10-valent pneumococcal conjugate vaccine predominated (90%), and resistance was detected mostly in isolates of serotypes 14 (61%), 23F (16%), 6B (10%), and 19F (3%). Multilocus sequence typing showed that 52% of the PEN-R isolates, and 89% of those with MICs ≥0.5 μg/mL, were sequence type (ST)-156 or single-locus variants of this ST (ST-557 or ST-4388); all of these isolates were serotype 14 and were assigned to the Spain9V-3 clone. Conclusions β-lactam resistance increased recently among cerebrospinal fluid isolates and was mainly due to the surge of the ST-4388, a previously undescribed gki single-locus variants of ST-156. Regional surveillance is shown to be essential to provide optimal antimicrobial therapy, monitor highly successful clones, and formulate adequate vaccination strategy.

Phenotypic and Molecular Characterization of Optochin-Resistant Streptococcus pneumoniae Isolates from Brazil, with Description of Five Novel Mutations in the atpC Gene

“…1). Most of the 16 different capsular types (1, 6A, 6B, 6C, 9N, 10A, 11A, 12F, 13, 14, 15C, 16F, 18C, 19A, 23A, and 23F) observed among the isolates included in the present study corresponded to types commonly found in our region (30,31), reinforcing the concept that serotype distribution among Opt r S. pneumoniae strains is mostly dependent on the epidemiological profile of each area (2,3,10,11,12). Identical serotypes were observed for the Opt r and Opt s subpopulations derived from the same culture.…”

Investigation of The Protective Effects of Beta-D-Glucan Against Invasive Encapsulated Streptococcus pneumoniae Sepsis in Splenectomized Rats

“…S.pneumoniae serotiplerinin tedavi süreçlerine karşı direnç geliştirmesi güncel bir sorundur. Bu durumda, antibiyotik tedavisinin yanında, aspleni ile oluşan immün yetmezliğin düzeltilmesi gerekebilir 6 . Beta-D-glukan (BDG), mantarlarda, mayada ve kepekte bulunan dallanmış bir glukoz polimeridir.…”

Which is the best? Palliative Radiation Therapy to Spleen or Splenectomy

“…Streptococcus pneumoniae, Haemophilus in luenzae and Neisseria meningitidis are the most common encapsulated microorganisms that have been found to be responsible for sepsis after splenectomy [19][20][21][22][23]. In blood culture of many patients with suspected sepsis, gram positive bacterium Streptococcus pneumoniae has been isolated in 50-90% of the time [23,25]. Yet the another retrospective study, in 66% of the cases pneumococcus were responsible for sepsis after splenectomy [25].…”

“…It is mostly seen in the irst two years after splenectomy and have high mortality rate of between 50-60% [4,5,13,[16][17][18]. Streptococcus pneumoniae, Haemophilus in luenzae and Neisseria meningitidis are the most common encapsulated microorganisms that have been found to be responsible for sepsis after splenectomy [19][20][21][22][23]. In blood culture of many patients with suspected sepsis, gram positive bacterium Streptococcus pneumoniae has been isolated in 50-90% of the time [23,25].…”

“…At this point, besides antibiotic effect, it may be necessary to strengthen the immune response. According to guidelines, in order to reduce morbidity and mortality, patient education, immunization and lifelong on-demand antimicrobial therapy are recommended [16,21,23,[26][27][28].…”