The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan
Background: A regional antibiotic susceptibility data of common pathogens is crucial to first-line physician for clinical judgment and appropriate selection of antimicrobial agents. The aim of this study is to update the epidemiology data of drug resistance of pneumococcus causing invasive pneumococ...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | Journal of Microbiology, Immunology and Infection |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118220300049 |
| _version_ | 1819122364164603904 |
|---|---|
| author | Meng-Chien Lee Kuang-Che Kuo Chen-Hsiang Lee Yu-Chia Hsieh Ming-Han Tsai Ching-Tai Huang Yhu-Chering Huang |
| author_facet | Meng-Chien Lee Kuang-Che Kuo Chen-Hsiang Lee Yu-Chia Hsieh Ming-Han Tsai Ching-Tai Huang Yhu-Chering Huang |
| author_sort | Meng-Chien Lee |
| collection | DOAJ |
| description | Background: A regional antibiotic susceptibility data of common pathogens is crucial to first-line physician for clinical judgment and appropriate selection of antimicrobial agents. The aim of this study is to update the epidemiology data of drug resistance of pneumococcus causing invasive pneumococcal disease (IPD) in adults. Methods: From the logbooks of microbiology laboratories, we retrospectively retrieved Streptococcus pneumoniae isolates, collected from normally sterile sites in adult patients in three hospitals in Taiwan from July 2011 to June 2015. Antibiotic resistance and serotypes of the isolates and clinical manifestations were further analyzed. Results: A total of 150 non-duplicated isolates were collected. According to CLSI meningitis breakpoint, the proportion of ceftriaxone non-susceptible pneumococcus (CNSP) showed an increasing trend from 4.5% in 2011 to > 40% in 2013–2015 (p = 0.007). Serotypes 19A and 23F were significantly associated with CNSP. Imipenem and meropenem had a relative low susceptible rate of 36.7% and 50.7%, respectively. Serotypes 6A, 14, 19A and 19F were significantly associated with the non-susceptibility to these carbepanems. Conclusion: The increase in the prevalence of CNSP using meningitis breakpoint was observed. For treating pneumococcal meningitis, empirical monotherapy with ceftriaxone might not be adequate. Imipenem and meropenem might not be a good choice for empirical treatment of adult IPDs. Antibiotic resistance of pneumococcus to ceftriaxone, cefepime, imipenem and meropenem were associated with 13-velent pneumococcal conjugate vaccine serotypes. |
| first_indexed | 2024-12-22T06:51:17Z |
| format | Article |
| id | doaj.art-d56e5b9549fe4f1fb956aaef8b95ba11 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-22T06:51:17Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-d56e5b9549fe4f1fb956aaef8b95ba112022-12-21T18:35:10ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-12-01536836844The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in TaiwanMeng-Chien Lee0Kuang-Che Kuo1Chen-Hsiang Lee2Yu-Chia Hsieh3Ming-Han Tsai4Ching-Tai Huang5Yhu-Chering Huang6Department of Emergency Medicine, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Corresponding author. Department of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan.Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Internal Medicine, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, TaiwanChang Gung University College of Medicine, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanChang Gung University College of Medicine, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanChang Gung University College of Medicine, Taoyuan, Taiwan; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanChang Gung University College of Medicine, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Corresponding author. Chang Gung University College of Medicine, Taoyuan, Taiwan.Background: A regional antibiotic susceptibility data of common pathogens is crucial to first-line physician for clinical judgment and appropriate selection of antimicrobial agents. The aim of this study is to update the epidemiology data of drug resistance of pneumococcus causing invasive pneumococcal disease (IPD) in adults. Methods: From the logbooks of microbiology laboratories, we retrospectively retrieved Streptococcus pneumoniae isolates, collected from normally sterile sites in adult patients in three hospitals in Taiwan from July 2011 to June 2015. Antibiotic resistance and serotypes of the isolates and clinical manifestations were further analyzed. Results: A total of 150 non-duplicated isolates were collected. According to CLSI meningitis breakpoint, the proportion of ceftriaxone non-susceptible pneumococcus (CNSP) showed an increasing trend from 4.5% in 2011 to > 40% in 2013–2015 (p = 0.007). Serotypes 19A and 23F were significantly associated with CNSP. Imipenem and meropenem had a relative low susceptible rate of 36.7% and 50.7%, respectively. Serotypes 6A, 14, 19A and 19F were significantly associated with the non-susceptibility to these carbepanems. Conclusion: The increase in the prevalence of CNSP using meningitis breakpoint was observed. For treating pneumococcal meningitis, empirical monotherapy with ceftriaxone might not be adequate. Imipenem and meropenem might not be a good choice for empirical treatment of adult IPDs. Antibiotic resistance of pneumococcus to ceftriaxone, cefepime, imipenem and meropenem were associated with 13-velent pneumococcal conjugate vaccine serotypes.http://www.sciencedirect.com/science/article/pii/S1684118220300049Invasive pneumococcus diseaseAntimicrobial susceptibilityCeftriaxoneCarbepenems |
| spellingShingle | Meng-Chien Lee Kuang-Che Kuo Chen-Hsiang Lee Yu-Chia Hsieh Ming-Han Tsai Ching-Tai Huang Yhu-Chering Huang The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan Journal of Microbiology, Immunology and Infection Invasive pneumococcus disease Antimicrobial susceptibility Ceftriaxone Carbepenems |
| title | The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan |
| title_full | The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan |
| title_fullStr | The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan |
| title_full_unstemmed | The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan |
| title_short | The antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination: A hospital-based observational study in Taiwan |
| title_sort | antimicrobial susceptibility in adult invasive pneumococcal disease in the era of pneumococcus vaccination a hospital based observational study in taiwan |
| topic | Invasive pneumococcus disease Antimicrobial susceptibility Ceftriaxone Carbepenems |
| url | http://www.sciencedirect.com/science/article/pii/S1684118220300049 |
| work_keys_str_mv | AT mengchienlee theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT kuangchekuo theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT chenhsianglee theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT yuchiahsieh theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT minghantsai theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT chingtaihuang theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT yhucheringhuang theantimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT mengchienlee antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT kuangchekuo antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT chenhsianglee antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT yuchiahsieh antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT minghantsai antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT chingtaihuang antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan AT yhucheringhuang antimicrobialsusceptibilityinadultinvasivepneumococcaldiseaseintheeraofpneumococcusvaccinationahospitalbasedobservationalstudyintaiwan |