Antibiotic Resistance Profiles and Multidrug Resistance Patterns of Streptococcus Pneumoniae in Pediatrics: A Multicenter Retrospective Study in Mainland China

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2019 Jun 14

PMID 31192930

Citations 33

Authors

Cai-Yun Wang

Ying-Hu Chen

Chao Fang

Ming-Ming Zhou

Hong-Mei Xu

Chun-Mei Jing

Hui-Ling Deng

Hui-Jun Cai

Kai Jia

Shu-Zhen Han

Hui Yu

Ai-Min Wang

Dan-Dan Yin

Chuan-Qing Wang

Wei Wang

Wei-Chun Huang

Ji-Kui Deng

Rui-Zhen Zhao

Yi-Ping Chen

Ji-Hong Yang

Chun Wang

Yan-Ran Che

Xiu-Zhen Nie

Shi-Fu Wang

Jian-Hua Hao

Cong-Hui Zhang

Affiliations

Soon will be listed here.

Abstract

Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide. Antibiotic resistance profiles for S pneumoniae isolates identified from pediatric patients in mainland China remains to be established.The clinical features, antimicrobial resistance, and multidrug resistance patterns of S pneumoniae were retrospectively analyzed at 10 children's hospitals in mainland China in 2016.Among the collected 6132 S pneumoniae isolates, pneumococcal diseases mainly occurred in children younger than 5 years old (85.1%). The resistance rate of S pneumoniae to clindamycin, erythromycin, tetracycline, and trimethoprim/sulfamethoxazole was 95.8%, 95.2%, 93.6%, and 66.7%, respectively. The resistance rates of S pneumoniae to penicillin were 86.9% and 1.4% in non-meningitis and meningitis isolates, while the proportions of ceftriaxone resistance were 8.2% and 18.1%, respectively. Pneumococcal conjugate vaccine was administered to only 4.1% of patients. Penicillin and ceftriaxone resistance, underling diseases, antibiotic resistant risk factors, and poor prognosis appeared more frequently in invasive pneumococcal diseases. The incidence of multidrug resistance (MDR) was 46.1% in patients with invasive pneumococcal disease which was more than in patients with non-invasive pneumococcal disease (18.3%). Patients with invasive pneumococcal disease usually have several MDR coexistence.S pneumoniae isolates showed high resistance to common antibiotics in mainland China. Penicillin and ceftriaxone resistance rate of invasive streptococcal pneumonia patients were significantly higher than that of non-invasive S pneumoniae patients. Alarmingly, 46.1% of invasive clinical isolates were multidrug resistant, so it is important to continued monitor the resistance of S pneumoniae when protein conjugate vaccine (PCV13) is coming in mainland China.

Citing Articles

The Evolution of the Antimicrobial Resistance of in Tunisia: A Multicentric Analysis over Two Decades (2000-2019).

Ben Ayed N, Gargouri O, Mhimdi S, Smaoui F, Mhiri E, Kanzari L Antibiotics (Basel). 2025; 14(2).

PMID: 40001415 PMC: 11851641. DOI: 10.3390/antibiotics14020171.

Development of a broad-spectrum epitope-based vaccine against Streptococcus pneumoniae.

Nahian M, Shahab M, Khan M, Akash S, Banu T, Sarkar M PLoS One. 2025; 20(1):e0317216.

PMID: 39820032 PMC: 11737669. DOI: 10.1371/journal.pone.0317216.

Identification of cell wall binding domains and repeats in phage endolysins: A molecular and diversity analysis.

Khan T, Mondal S, Mahmud A, Karim D, Draper L, Hill C Biochem Biophys Rep. 2024; 40:101844.

PMID: 39483175 PMC: 11525621. DOI: 10.1016/j.bbrep.2024.101844.

Assessment of the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients: A retrospective study.

Davarpanah M, Vares Vazirian S J Family Med Prim Care. 2024; 13(9):3647-3652.

PMID: 39464903 PMC: 11504767. DOI: 10.4103/jfmpc.jfmpc_67_24.

Serotype, antibiotic susceptibility and whole-genome characterization of in all age groups living in Southwest China during 2018-2022.

Miao C, Yan Z, Chen C, Kuang L, Ao K, Li Y Front Microbiol. 2024; 15:1342839.

PMID: 38362498 PMC: 10867222. DOI: 10.3389/fmicb.2024.1342839.

References

Hackel M, Lascols C, Bouchillon S, Hilton B, Morgenstern D, Purdy J . Serotype prevalence and antibiotic resistance in Streptococcus pneumoniae clinical isolates among global populations. Vaccine. 2013; 31(42):4881-7. DOI: 10.1016/j.vaccine.2013.07.054. View

Song J, Thamlikitkul V, Hsueh P . Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region. Int J Antimicrob Agents. 2011; 38(2):108-17. DOI: 10.1016/j.ijantimicag.2011.02.017. View

Xue L, Yao K, Xie G, Zheng Y, Wang C, Shang Y . Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates that cause invasive disease among Chinese children. Clin Infect Dis. 2010; 50(5):741-4. DOI: 10.1086/650534. View

Geng Q, Zhang T, Ding Y, Tao Y, Lin Y, Wang Y . Molecular characterization and antimicrobial susceptibility of Streptococcus pneumoniae isolated from children hospitalized with respiratory infections in Suzhou, China. PLoS One. 2014; 9(4):e93752. PMC: 3977860. DOI: 10.1371/journal.pone.0093752. View

Sader H, Farrell D, Flamm R, Jones R . Antimicrobial susceptibility of Gram-negative organisms isolated from patients hospitalised with pneumonia in US and European hospitals: results from the SENTRY Antimicrobial Surveillance Program, 2009-2012. Int J Antimicrob Agents. 2014; 43(4):328-34. DOI: 10.1016/j.ijantimicag.2014.01.007. View

Kim S, Song J, Chung D, Thamlikitkul V, Yang Y, Wang H . Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrob Agents Chemother. 2012; 56(3):1418-26. PMC: 3294909. DOI: 10.1128/AAC.05658-11. View

Suzuki K, Nishimaki K, Okuyama K, Katoh T, Yasujima M, Chihara J . Trends in antimicrobial susceptibility of Streptococcus pneumoniae in the Tohoku district of Japan: a longitudinal analysis from 1998 to 2007. Tohoku J Exp Med. 2010; 220(1):47-57. DOI: 10.1620/tjem.220.47. View

Pan F, Han L, Huang W, Tang J, Xiao S, Wang C . Serotype Distribution, Antimicrobial Susceptibility, and Molecular Epidemiology of Streptococcus pneumoniae Isolated from Children in Shanghai, China. PLoS One. 2015; 10(11):e0142892. PMC: 4646667. DOI: 10.1371/journal.pone.0142892. View

. Pneumococcal conjugate vaccine for childhood immunization--WHO position paper. Wkly Epidemiol Rec. 2007; 82(12):93-104. View

10.

Jacobs M, Felmingham D, Appelbaum P, Gruneberg R . The Alexander Project 1998-2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J Antimicrob Chemother. 2003; 52(2):229-46. DOI: 10.1093/jac/dkg321. View

11.

Wessels E, Schelfaut J, Bernards A, Claas E . Evaluation of several biochemical and molecular techniques for identification of Streptococcus pneumoniae and Streptococcus pseudopneumoniae and their detection in respiratory samples. J Clin Microbiol. 2012; 50(4):1171-7. PMC: 3318541. DOI: 10.1128/JCM.06609-11. View

12.

Hicks L, Monnet D, Roberts R . Increase in pneumococcus macrolide resistance, USA. Emerg Infect Dis. 2010; 16(5):896-7. PMC: 2953996. DOI: 10.3201/eid1605.091424. View

13.

Ceyhan M, Ozsurekci Y, Gurler N, Oksuz L, Aydemir S, Ozkan S . Serotype distribution of Streptococcus pneumoniae in children with invasive diseases in Turkey: 2008-2014. Hum Vaccin Immunother. 2015; 12(2):308-13. PMC: 5049732. DOI: 10.1080/21645515.2015.1078952. View

14.

Tarallo L, Tancredi F, Schito G, Marchese A, Bella A . Active surveillance of Streptococcus pneumoniae bacteremia in Italian children. Vaccine. 2006; 24(47-48):6938-43. DOI: 10.1016/j.vaccine.2006.05.012. View

15.

Wu C, Ku S, Yang K, Fang W, Tu C, Chen C . Antimicrobial drug-resistant microbes associated with hospitalized community-acquired and healthcare-associated pneumonia: a multi-center study in Taiwan. J Formos Med Assoc. 2013; 112(1):31-40. DOI: 10.1016/j.jfma.2011.09.028. View

16.

Inoue M, Farrell D, Kaneko K, Akizawa K, Fujita S, Kaku M . Antimicrobial susceptibility of respiratory tract pathogens in Japan during PROTEKT years 1-5 (1999-2004). Microb Drug Resist. 2008; 14(2):109-17. DOI: 10.1089/mdr.2008.0806. View

17.

Ramirez J, Anzueto A . Changing needs of community-acquired pneumonia. J Antimicrob Chemother. 2011; 66 Suppl 3:iii3-9. PMC: 3143426. DOI: 10.1093/jac/dkr094. View

18.

Wang H, Chen M, Xu Y, Sun H, Yang Q, Hu Y . Antimicrobial susceptibility of bacterial pathogens associated with community-acquired respiratory tract infections in Asia: report from the Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS) study, 2009-2010. Int J Antimicrob Agents. 2011; 38(5):376-83. DOI: 10.1016/j.ijantimicag.2011.06.015. View

19.

Liu C, Xiong X, Xu W, Sun J, Wang L, Li J . Serotypes and patterns of antibiotic resistance in strains causing invasive pneumococcal disease in children less than 5 years of age. PLoS One. 2013; 8(1):e54254. PMC: 3544833. DOI: 10.1371/journal.pone.0054254. View

20.

Song J, Jung S, Ko K, Kim N, Son J, Chang H . High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother. 2004; 48(6):2101-7. PMC: 415617. DOI: 10.1128/AAC.48.6.2101-2107.2004. View