High prevalence of multidrug-resistant Streptococcus pneumoniae among children in a rural Kentucky community

Marine mammals have been described as sentinels of the health of marine ecosystems. Therefore, the aim of this study was to investigate (i) the presence of extended-spectrum β-lactamase (ESBL)- and AmpC-producing Enterobacterales, which comprise several bacterial families important to the healthcare sector, as well as (ii) the presence of Salmonella in these coastal animals. The antimicrobial resistance pheno- and genotypes, as well as biocide susceptibility of Enterobacterales isolated from stranded marine mammals, were determined prior to their rehabilitation. All E. coli isolates (n = 27) were screened for virulence genes via DNA-based microarray, and twelve selected E. coli isolates were analyzed by whole-genome sequencing. Seventy-one percent of the Enterobacterales isolates exhibited a multidrug-resistant (MDR) pheno- and genotype. The gene blaCMY (n = 51) was the predominant β-lactamase gene. In addition, blaTEM-1 (n = 38), blaSHV-33 (n = 8), blaCTX-M-15 (n = 7), blaOXA-1 (n = 7), blaSHV-11 (n = 3), and blaDHA-1 (n = 2) were detected. The most prevalent non-β-lactamase genes were sul2 (n = 38), strA (n = 34), strB (n = 34), and tet(A) (n = 34). Escherichia coli isolates belonging to the pandemic sequence types (STs) ST38, ST167, and ST648 were identified. Among Salmonella isolates (n = 18), S. Havana was the most prevalent serotype. The present study revealed a high prevalence of MDR bacteria and the presence of pandemic high-risk clones, both of which are indicators of anthropogenic antimicrobial pollution, in marine mammals.

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Need for Annual Surveillance of Antimicrobial Resistance in Streptococcus pneumoniae in the United States: 2-Year Longitudinal Analysis

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.45.4.1037-1042.2001 ◽

2001 ◽

Vol 45 (4) ◽

pp. 1037-1042 ◽

Cited By ~ 94

Author(s):

Daniel F. Sahm ◽

James A. Karlowsky ◽

Laurie J. Kelly ◽

Ian A. Critchley ◽

Mark E. Jones ◽

...

Keyword(s):

United States ◽

Streptococcus Pneumoniae ◽

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

The United States ◽

Multidrug Resistant ◽

Fluoroquinolone Resistance ◽

Resistance Patterns ◽

Changing Patterns ◽

Resistance To Penicillin

ABSTRACT Although changing patterns in antimicrobial resistance inStreptococcus pneumoniae have prompted several surveillance initiatives in recent years, the frequency with which these studies are needed has not been addressed. To approach this issue, the extent to which resistance patterns change over a 1-year period was examined. In this study we analyzed S. pneumoniaeantimicrobial susceptibility results produced in our laboratory with isolates obtained over 2 consecutive years (1997–1998 and 1998–1999) from the same 96 institutions distributed throughout the United States. Comparison of results revealed increases in resistant percentages for all antimicrobial agents studied except vancomycin. For four of the agents tested (penicillin, cefuroxime, trimethoprim-sulfamethoxazole, and levofloxacin), the increases were statistically significant (P < 0.05). Resistance to the fluoroquinolone remained low in both years (0.1 and 0.6%, respectively); in contrast, resistance to macrolides was consistently greater than 20%, and resistance to trimethoprim-sulfamethoxazole increased from 13.3 to 27.3%. Multidrug resistance, concurrent resistance to three or more antimicrobials of different chemical classes, also increased significantly between years, from 5.9 to 11%. The most prevalent phenotype was resistance to penicillin, azithromycin (representative macrolide), and trimethoprim-sulfamethoxazole. Multidrug-resistant phenotypes that included fluoroquinolone resistance were uncommon; however, two phenotypes that included fluoroquinolone resistance not found in 1997–1998 were encountered in 1998–1999. This longitudinal surveillance study of resistance inS. pneumoniae revealed that significant changes do occur in just a single year and supports the need for surveillance at least on an annual basis, if not continuously.

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Streptococcus pneumoniae carriage in school children

Medical alphabet ◽

10.33667/2078-5631-2021-30-57-60 ◽

2021 ◽

Vol 1 (30) ◽

pp. 57-60

Author(s):

I. N. Protasova ◽

N. V. Bakhareva ◽

N. A. Ilyenkova ◽

E. S. Sokolovskaya ◽

T. A. Elistratova ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Antimicrobial Resistance ◽

School Children ◽

Clonal Diversity ◽

Multidrug Resistant ◽

Clonal Structure ◽

Serotype Distribution ◽

Antibiotic Resistant ◽

Oropharyngeal Swab ◽

Resistant Strains

Purpose. To investigate the serotype distribution, clonal structure and antimicrobial resistance of pneumococci isolated from schoolchildren.Materials and methods. During the period from 2012 to 2018 we examined 498 healthy school children aged 6 to 17 years. Oropharyngeal swab was taken from each child for culture, after that all S. pneumoniae strains were genotyped for serotype and ST-type deduction (PCR and sequencing, respectively). Antimicrobial resistance was also determined.Results. Pneumococcal culture was positive in 10.6 % of children. S. pneumoniae isolates belonged to seven serogroups and seven serotypes. Serogroup 6 and serotype 19F strains (15.1% each), and serogroup 9 strains (13.2%) were the most prevalent. S. pneumoniae33FA/37 and 3 (9.4 and 5.7%), serogroups 15 and 18 (7.6 and 5.7%), and 10A serotype (3.8%) were determined at a lower frequency. 20 detected ST-types belonged to 14 clonal complexes (CCs); CC156, CC447, and CC320 were predominant. 1.9% of isolates were penicillin-resistant; 13.2% – macrolide-, clindamycin-, and tetracycline-resistant. S. pneumoniae antibiotic resistant strains belonged to multidrug-resistant CCs 320, 315, and 156.Conclusion. S. pneumoniae prevalence in school children is not high. Pneumococcal population is characterized by serotype and clonal diversity including ‘invasive’ serotypes and genotypes. Most of strains are susceptible to antimicrobials.

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Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

MedPharmRes ◽

10.32895/ump.mpr.5.2.4 ◽

2021 ◽

Vol 5 (2) ◽

pp. 17-21

Author(s):

Lam Nguyen-Ho ◽

Duong Hoang-Thai ◽

Vu Le-Thuong ◽

Ngoc Tran-Van

Keyword(s):

Risk Factor ◽

Antimicrobial Resistance ◽

Multidrug Resistant ◽

Community Acquired Pneumonia ◽

Resistant Organism ◽

Healthcare Associated Infection ◽

Female Ratio ◽

High Prevalence ◽

Need To Evaluate ◽

Healthcare Associated

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

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