Genotyping and serotyping of macrolide and multidrug resistant Streptococcus pneumoniae isolated from carrier children

Aims:Streptococcus pneumoniae, an opportunistic pathogen commonly carried asymptomatically in the nasopharynx of children, is associated with increasing rates of treatment failures due to a worldwide increase in drug resistance. We investigated the carriage of S. pneumoniae in children 5 years or yo...

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Veröffentlicht in:Indian journal of medical microbiology 2016-04, Vol.34 (2), p.159-165
Hauptverfasser: Swedan, SF, Hayajneh, WA, Bshara, GN
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Hayajneh, WA
Bshara, GN
description Aims:Streptococcus pneumoniae, an opportunistic pathogen commonly carried asymptomatically in the nasopharynx of children, is associated with increasing rates of treatment failures due to a worldwide increase in drug resistance. We investigated the carriage of S. pneumoniae in children 5 years or younger, the identity of prevalent serotypes, the rates of resistance to macrolides and other antimicrobial agents and the genotypes responsible for macrolide resistance. Materials and Methods: Nasopharyngeal swabs were collected from 157 children under 5 years for cultural isolation of S. pneumoniae. Antibiogram of isolates was determined using the disk diffusion test, and the minimal inhibitory concentration to macrolides was determined using the E-test. Isolate serotypes and macrolide resistance genes, erm(B) and mef(E), were identified using multiplex polymerase chain reactions. Results:S. pneumoniae was recovered from 33.8% of children; 41.9% among males and 21.9% among females (P = 0.009). The highest carriage rate occurred among age groups 7–12 months and 49–60 months. Most frequent serotypes were 19F, 6A/B, 11A, 19A, 14 and 15B/C. Resistance to macrolides was 60.4%. Resistance to oxacillin, trimethoprim/ sulfamethoxazole and clindamycin was present among 90.6%, 54.7% and 32.1% of isolates, respectively. All isolates were susceptible to chloramphenicol, levofloxacin and vancomycin. Isolates resistant to one or more macrolide drugs were more likely to be multidrug resistant. Resistance to clindamycin or oxacillin coexisted with macrolide resistance. Among the erythromycin-resistant isolates, erm(B), mef(E) and erm(B) and mef(E) genes were present at rates of 43.8%, 37.5% and 6.3%, respectively. Erm(B) and mef(E) were associated with very high level and moderate-to-high level resistance to macrolides, respectively. Conclusion: A significant proportion of children harboured macrolide and multidrug-resistant S. pneumoniae.
doi_str_mv 10.4103/0255-0857.176840
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We investigated the carriage of S. pneumoniae in children 5 years or younger, the identity of prevalent serotypes, the rates of resistance to macrolides and other antimicrobial agents and the genotypes responsible for macrolide resistance. Materials and Methods: Nasopharyngeal swabs were collected from 157 children under 5 years for cultural isolation of S. pneumoniae. Antibiogram of isolates was determined using the disk diffusion test, and the minimal inhibitory concentration to macrolides was determined using the E-test. Isolate serotypes and macrolide resistance genes, erm(B) and mef(E), were identified using multiplex polymerase chain reactions. Results:S. pneumoniae was recovered from 33.8% of children; 41.9% among males and 21.9% among females (P = 0.009). The highest carriage rate occurred among age groups 7–12 months and 49–60 months. Most frequent serotypes were 19F, 6A/B, 11A, 19A, 14 and 15B/C. Resistance to macrolides was 60.4%. Resistance to oxacillin, trimethoprim/ sulfamethoxazole and clindamycin was present among 90.6%, 54.7% and 32.1% of isolates, respectively. All isolates were susceptible to chloramphenicol, levofloxacin and vancomycin. Isolates resistant to one or more macrolide drugs were more likely to be multidrug resistant. Resistance to clindamycin or oxacillin coexisted with macrolide resistance. Among the erythromycin-resistant isolates, erm(B), mef(E) and erm(B) and mef(E) genes were present at rates of 43.8%, 37.5% and 6.3%, respectively. Erm(B) and mef(E) were associated with very high level and moderate-to-high level resistance to macrolides, respectively. Conclusion: A significant proportion of children harboured macrolide and multidrug-resistant S. pneumoniae.</description><identifier>ISSN: 0255-0857</identifier><identifier>EISSN: 1998-3646</identifier><identifier>DOI: 10.4103/0255-0857.176840</identifier><identifier>PMID: 27080766</identifier><language>eng</language><publisher>India: Elsevier B.V</publisher><subject>Age ; Anti-Bacterial Agents - pharmacology ; Antimicrobial agents ; Antimicrobial resistance ; Binding sites ; Carrier State - microbiology ; Child, Preschool ; colonisation ; Conflicts of interest ; Drug resistance ; Drug Resistance, Multiple, Bacterial ; Family medical history ; Female ; Gene expression ; Genotype ; Genotype &amp; phenotype ; Hospitals ; Humans ; Immunization ; Infant ; Jordan ; Macrolides - pharmacology ; Male ; Microbial Sensitivity Tests ; Multiplex Polymerase Chain Reaction ; Nasopharynx - microbiology ; Pneumococcal Infections - microbiology ; Pneumonia ; prevalence ; Serogroup ; Streptococcus infections ; Streptococcus pneumoniae ; Streptococcus pneumoniae - classification ; Streptococcus pneumoniae - drug effects ; Streptococcus pneumoniae - isolation &amp; purification ; Vaccines</subject><ispartof>Indian journal of medical microbiology, 2016-04, Vol.34 (2), p.159-165</ispartof><rights>2016 Indian Journal of Medical Microbiology</rights><rights>Copyright Medknow Publications &amp; Media Pvt Ltd Apr-Jun 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512i-28247ad0d17999444e0663aa6a4a623211159db15072da2745a6be9e224a03df3</citedby><cites>FETCH-LOGICAL-c512i-28247ad0d17999444e0663aa6a4a623211159db15072da2745a6be9e224a03df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1807358050?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,27923,27924,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27080766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swedan, SF</creatorcontrib><creatorcontrib>Hayajneh, WA</creatorcontrib><creatorcontrib>Bshara, GN</creatorcontrib><title>Genotyping and serotyping of macrolide and multidrug resistant Streptococcus pneumoniae isolated from carrier children</title><title>Indian journal of medical microbiology</title><addtitle>Indian J Med Microbiol</addtitle><description>Aims:Streptococcus pneumoniae, an opportunistic pathogen commonly carried asymptomatically in the nasopharynx of children, is associated with increasing rates of treatment failures due to a worldwide increase in drug resistance. We investigated the carriage of S. pneumoniae in children 5 years or younger, the identity of prevalent serotypes, the rates of resistance to macrolides and other antimicrobial agents and the genotypes responsible for macrolide resistance. Materials and Methods: Nasopharyngeal swabs were collected from 157 children under 5 years for cultural isolation of S. pneumoniae. Antibiogram of isolates was determined using the disk diffusion test, and the minimal inhibitory concentration to macrolides was determined using the E-test. Isolate serotypes and macrolide resistance genes, erm(B) and mef(E), were identified using multiplex polymerase chain reactions. Results:S. pneumoniae was recovered from 33.8% of children; 41.9% among males and 21.9% among females (P = 0.009). The highest carriage rate occurred among age groups 7–12 months and 49–60 months. Most frequent serotypes were 19F, 6A/B, 11A, 19A, 14 and 15B/C. Resistance to macrolides was 60.4%. Resistance to oxacillin, trimethoprim/ sulfamethoxazole and clindamycin was present among 90.6%, 54.7% and 32.1% of isolates, respectively. All isolates were susceptible to chloramphenicol, levofloxacin and vancomycin. Isolates resistant to one or more macrolide drugs were more likely to be multidrug resistant. Resistance to clindamycin or oxacillin coexisted with macrolide resistance. Among the erythromycin-resistant isolates, erm(B), mef(E) and erm(B) and mef(E) genes were present at rates of 43.8%, 37.5% and 6.3%, respectively. Erm(B) and mef(E) were associated with very high level and moderate-to-high level resistance to macrolides, respectively. Conclusion: A significant proportion of children harboured macrolide and multidrug-resistant S. pneumoniae.</description><subject>Age</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antimicrobial agents</subject><subject>Antimicrobial resistance</subject><subject>Binding sites</subject><subject>Carrier State - microbiology</subject><subject>Child, Preschool</subject><subject>colonisation</subject><subject>Conflicts of interest</subject><subject>Drug resistance</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Family medical history</subject><subject>Female</subject><subject>Gene expression</subject><subject>Genotype</subject><subject>Genotype &amp; phenotype</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infant</subject><subject>Jordan</subject><subject>Macrolides - pharmacology</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Multiplex Polymerase Chain Reaction</subject><subject>Nasopharynx - microbiology</subject><subject>Pneumococcal Infections - microbiology</subject><subject>Pneumonia</subject><subject>prevalence</subject><subject>Serogroup</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Streptococcus pneumoniae - classification</subject><subject>Streptococcus pneumoniae - drug effects</subject><subject>Streptococcus pneumoniae - isolation &amp; 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We investigated the carriage of S. pneumoniae in children 5 years or younger, the identity of prevalent serotypes, the rates of resistance to macrolides and other antimicrobial agents and the genotypes responsible for macrolide resistance. Materials and Methods: Nasopharyngeal swabs were collected from 157 children under 5 years for cultural isolation of S. pneumoniae. Antibiogram of isolates was determined using the disk diffusion test, and the minimal inhibitory concentration to macrolides was determined using the E-test. Isolate serotypes and macrolide resistance genes, erm(B) and mef(E), were identified using multiplex polymerase chain reactions. Results:S. pneumoniae was recovered from 33.8% of children; 41.9% among males and 21.9% among females (P = 0.009). The highest carriage rate occurred among age groups 7–12 months and 49–60 months. Most frequent serotypes were 19F, 6A/B, 11A, 19A, 14 and 15B/C. Resistance to macrolides was 60.4%. Resistance to oxacillin, trimethoprim/ sulfamethoxazole and clindamycin was present among 90.6%, 54.7% and 32.1% of isolates, respectively. All isolates were susceptible to chloramphenicol, levofloxacin and vancomycin. Isolates resistant to one or more macrolide drugs were more likely to be multidrug resistant. Resistance to clindamycin or oxacillin coexisted with macrolide resistance. Among the erythromycin-resistant isolates, erm(B), mef(E) and erm(B) and mef(E) genes were present at rates of 43.8%, 37.5% and 6.3%, respectively. Erm(B) and mef(E) were associated with very high level and moderate-to-high level resistance to macrolides, respectively. Conclusion: A significant proportion of children harboured macrolide and multidrug-resistant S. pneumoniae.</abstract><cop>India</cop><pub>Elsevier B.V</pub><pmid>27080766</pmid><doi>10.4103/0255-0857.176840</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Age
Anti-Bacterial Agents - pharmacology
Antimicrobial agents
Antimicrobial resistance
Binding sites
Carrier State - microbiology
Child, Preschool
colonisation
Conflicts of interest
Drug resistance
Drug Resistance, Multiple, Bacterial
Family medical history
Female
Gene expression
Genotype
Genotype & phenotype
Hospitals
Humans
Immunization
Infant
Jordan
Macrolides - pharmacology
Male
Microbial Sensitivity Tests
Multiplex Polymerase Chain Reaction
Nasopharynx - microbiology
Pneumococcal Infections - microbiology
Pneumonia
prevalence
Serogroup
Streptococcus infections
Streptococcus pneumoniae
Streptococcus pneumoniae - classification
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - isolation & purification
Vaccines
title Genotyping and serotyping of macrolide and multidrug resistant Streptococcus pneumoniae isolated from carrier children
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