Surveillance of antibiotic resistance of Streptococcus pneumoniae in the Czech Republic, respiratory study results, 2010–2017
Authors:
L. Mališová 1; P. Urbášková 1; V. Jakubů 1,4; P. Španělová 1; J. Kozáková 2
; M. Musílek 2; H. Žemličková 1,4
Authors place of work:
Centrum epidemiologie a mikrobiologie, Národní referenční laboratoř pro antibiotika, Státní zdravotní ústav, Praha
1; Centrum epidemiologie a mikrobiologie, Národní referenční laboratoř pro streptokokové nákazy, Státní zdravotní ústav, Praha
2; Centrum epidemiologie a mikrobiologie, Národní referenční laboratoř pro meningokokové nákazy, Státní zdravotní ústav, Praha
3; Ústav klinické mikrobiologie, Lékařská fakulta Univerzity Karlovy v Hradci Králové a Fakultní nemocnice, Hradec Králové
4
Published in the journal:
Epidemiol. Mikrobiol. Imunol. 68, 2019, č. 2, s. 75-81
Category:
Original Papers
Summary
Aim: The purpose of the surveillance performed from October to December in 2010-2017 was to monitor the trends in the susceptibility to beta-lactam and macrolide antibiotics in Streptococcus pneumoniae isolates from respiratory tract infections in the Czech Republic.
Material and methods: Between 42 and 55 laboratories participated in the study every year. Consecutive non-duplicate pneumococcal isolates from relevant microbiological specimens from patients with community-acquired bacterial respiratory tract infection were sequentially included in the study. Laboratories recorded qualitative results of penicillin and erythromycin susceptibility testing; susceptibility to antibiotics was determined by the disk diffusion method. Penicillin non-susceptible and/or erythromycin resistant isolates were referred to the National Reference Laboratory for Antibiotics, where the minimum inhibitory concentration of each antibiotic was tested using the broth microdilution method, and their serotyping was performed in the National Reference Laboratory for Streptococcal Infections. Twenty-six isolates from 2017 were analysed by the multilocus sequence typing method.
Results: In total, 7 491 pneumococcal strains were examined, of which 53.7% (4 023) were from the upper respiratory tract and 47.7% (3 573) from children under 15 years of age. Non-susceptibility to penicillin decreased from 2.6% in 2010 to 1.2% in 2017, while resistance to erythromycin increased from 7.4% to 9.7% over the same period. Penicillin non-susceptible isolates were mostly of serotypes 19A, 19F, and 15A. Macrolide resistant but penicillin susceptible isolates were predominantly represented by serotypes 19A and 3. The presence of the Taiwan19F-14 clone was confirmed in penicillin non-susceptible isolates by MLST, and the most frequently identified sequence type (ST) in macrolide resistant isolates was ST416 classified into the Netherlands15B-37 clone.
Conclusions: The respiratory study of antibiotic resistance in S. pneumoniae confirmed the decreasing trend of resistance to penicillin but revealed a growing resistance to macrolide antibiotics in the Czech Republic. The results of our study confirm that antibiotic resistance in the vaccination era is associated primarily with the non-vaccine serotypes, and the clonal expansion of macrolide resistant serotype 19A was apparently supported by the growing prescription of macrolide antibiotics.
Keywords:
Streptococcus pneumoniae – respiratory study – penicillin – erythromycin – MLST
Zdroje
1. Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet, 2005;365:579–587.
2. Mainous AG, Hueston WJ, Davis MP, Pearson WS. Trends in antimicrobial prescribing for bronchitis and upper respiratory infections among adults and children. Am J Public Health, 2003;93:1910–1914.
3. Jacobs MR, Felmingham D, Appelbaum PC, Grüneberg RN, et al. The Alexander project 1998–2002: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J Antimicrob Chemother, 2003;52:229–246.
4. Appelbaum PC, Bhamjee A, Scragg JN, et al. Streptococcus pneumoniae resistant to penicillin and chloramphenicol. Lancet, 1977;2:995–997.
5. Jacobs MR, Koornhof JH, Robins-Browne RM, et al. Emergence of multiply resistant pneumococci. N Engl J Med, 1978;299:735–740.
6. Reinert RR, Reinert S, van der Linden M, et al. Antimicrobial susceptibility of Streptococcus pneumoniae in eight European countries from 2001 to 2003. Antimicrob Agents Chemother, 2005;49:2903–2913.
7. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2017. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2017.
8. Urbášková P. Rezistence k antibiotikům u Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae a Moraxella catarrhalis v České republice v letech 1996 a 1997. Klin Microbiol Inf Lék, 1998;4:292–298.
9. Sorensen UB. Typing of pneumococci by using 12 pooled antisera. J Clin Microbiol, 1993; 31:2097–2100.
10. Vacková Z, Klímová M, Kozáková J. Nová metoda a schéma typizace Streptococcus pneumoniae. Epidemiol Mikrobiol Imunol, 2013;62:10–18.
11. European Committee on Antimicrobial Susceptibility Testing (EUCAST) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Determination of minimum inhibitory concentrations (MICs) of antibacterial agents by broth dilution. Clin Microbiol Infect, 2003;9:1–7.
12. Enright MC, Spratt BG. A multilocus sequence typing scheme for Streptococcus pneumoniae: identification of clones associated with serious invasive disease. Microbiology, 1998;144:3049–3060.
13. Klugmann KP. Risk factors for antibiotic resistance in Streptococcus pneumoniae. S Afr Med J, 2007;97:1129–1132.
14. Riedel S, Beekmann SE, Heilmann KP, et al. Antimicrobial use in Europe and antimicrobial resistance in Streptococcus pneumoniae. Eur J Clin Microbiol Infect Dis, 2007; 26:485–490.
15. Baquero F. Trends in antibiotic resistance of respiratory pathogens: an analysis and commentary on a collaborative surveillance study.
J Antimicrob Chemother, 1996;38 (Suppl A):117–132.
16. Žemličková H, Mališová L, Španělová P, et al. Molecular characterization of serogroup 19 Streptococcus pneumoniae in the Czech Republic in the post-vaccine era. J Med Microbiol, 2018;67:1003–1011.
17. Del Grosso M, Northwood JGE, Farell DJ, Pantosti A. The macrolide resistance genes erm(B) and mef(E) are carried by Tn2010 in dual-gene Streptococcus pneumoniae isolates belonging to clonal complex CC271. Antimicrob Agents Chemother, 2007;51:4184–4186.
18. Zemlickova H, Melter O, Urbaskova P. Epidemiological relation-
ships among penicillin non-susceptible Streptococcus pneumoniae strains recovered in the Czech Republic. J Med Microbiol, 2006;55:437–442.
19. Moore RM, Gertz RE, Woodbury RL, et al. Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005. J Infect Dis, 2008;197:1016–1027.
20. Del Grosso M, Camilli R, D’Ambrosio F, et al. Increase of pneumococcal serotype 19A in Italy is due to expansion of the piliated clone ST416/CC199. J Med Microbiol, 2013;62: 1220–1225.
21. van der Linden M, Reinert RR, Kern WV, Imohl M. Epidemiology of serotype 19A isolates from invasive pneumococcal disease in German children. BMC Infect Dis, 2013;13: 70.
22. Camilli R, D’Ambrosio F, Del Grosso M, et al. Impact of pneumo-
coccal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure. Vaccine, 2017;35:4587–4593.
23. Kozáková J, Okonji Z, Šebestová H, Křížová P. Invasive pneumococcal disease in the Czech Republic in 2015. Bull Centre Epidemiol Microbiol, 2018;27:49–55.
24. Vancikova Z, Trojanek M, Zemlickova H, et al. Pneumococcal urinary antigen positivity in healthy colonized children: is it age dependent? Wien Klin Wochenschr, 2013;125:495–500.
Štítky
Hygiene and epidemiology Medical virology Clinical microbiologyČlánok vyšiel v časopise
Epidemiology, Microbiology, Immunology
2019 Číslo 2
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