Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone.
Surveillance for Streptococcus pneumoniae resistant to penicillin and other antimicrobial agents is necessary to define the optimal empirical antibiotic therapy for meningitis in resource-poor countries such as Vietnam. The clinical and microbiological features of 100 patients admitted to the Centre...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2002
|
| _version_ | 1826293290809425920 |
|---|---|
| author | Parry, C Duong, N Zhou, J Mai, N Diep, T Thinh, L Wain, J Van Vinh Chau, N Griffiths, D Day, N White, N Hien, T Spratt, BG Farrar, J |
| author_facet | Parry, C Duong, N Zhou, J Mai, N Diep, T Thinh, L Wain, J Van Vinh Chau, N Griffiths, D Day, N White, N Hien, T Spratt, BG Farrar, J |
| author_sort | Parry, C |
| collection | OXFORD |
| description | Surveillance for Streptococcus pneumoniae resistant to penicillin and other antimicrobial agents is necessary to define the optimal empirical antibiotic therapy for meningitis in resource-poor countries such as Vietnam. The clinical and microbiological features of 100 patients admitted to the Centre for Tropical Diseases in Ho Chi Minh City, Vietnam, between 1993 and 2002 with invasive pneumococcal disease were studied. A penicillin-nonsusceptible pneumococcus (MIC, > or =0.1 micro g/ml) was isolated from the blood or cerebrospinal fluid of 8% of patients (2 of 24) between 1993 and 1995 but 56% (20 of 36) during 1999 to 2002 (P < 0.0001). Pneumococcal isolates resistant to penicillin (MIC, > or =2.0 micro g/ml) increased from 0% (0 of 24) to 28% (10 of 36) (P = 0.002). Only one isolate was ceftriaxone resistant (MIC, 2.0 micro g/ml). Penicillin-nonsusceptible pneumococci were isolated from 78% of children younger than 15 years (28 of 36) compared with 25% of adults (16 of 64) (P = 0.0001). Isolation of a penicillin-nonsusceptible pneumococcus in adults with meningitis was independently associated with referral from another hospital (P = 0.005) and previous antibiotic therapy (P = 0.025). Multilocus sequence typing showed that 86% of the invasive penicillin-resistant pneumococcus isolates tested (12 of 14) were of the Spain(23F)-1 clone. The serotypes of >95% of the penicillin-nonsusceptible pneumococci were included in the currently available pneumococcal vaccines. Our findings point to the recent introduction and spread of the Spain(23F)-1 clone of penicillin-resistant pneumococci in Vietnam. Simple clinical predictors can be used to guide empirical antibiotic therapy of meningitis. Pneumococcal vaccination may help to control this problem. |
| first_indexed | 2024-03-07T03:27:50Z |
| format | Journal article |
| id | oxford-uuid:b9ab37fe-9377-4ad5-9c9a-fb837f645865 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:27:50Z |
| publishDate | 2002 |
| record_format | dspace |
| spelling | oxford-uuid:b9ab37fe-9377-4ad5-9c9a-fb837f6458652022-03-27T05:04:29ZEmergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b9ab37fe-9377-4ad5-9c9a-fb837f645865EnglishSymplectic Elements at Oxford2002Parry, CDuong, NZhou, JMai, NDiep, TThinh, LWain, JVan Vinh Chau, NGriffiths, DDay, NWhite, NHien, TSpratt, BGFarrar, JSurveillance for Streptococcus pneumoniae resistant to penicillin and other antimicrobial agents is necessary to define the optimal empirical antibiotic therapy for meningitis in resource-poor countries such as Vietnam. The clinical and microbiological features of 100 patients admitted to the Centre for Tropical Diseases in Ho Chi Minh City, Vietnam, between 1993 and 2002 with invasive pneumococcal disease were studied. A penicillin-nonsusceptible pneumococcus (MIC, > or =0.1 micro g/ml) was isolated from the blood or cerebrospinal fluid of 8% of patients (2 of 24) between 1993 and 1995 but 56% (20 of 36) during 1999 to 2002 (P < 0.0001). Pneumococcal isolates resistant to penicillin (MIC, > or =2.0 micro g/ml) increased from 0% (0 of 24) to 28% (10 of 36) (P = 0.002). Only one isolate was ceftriaxone resistant (MIC, 2.0 micro g/ml). Penicillin-nonsusceptible pneumococci were isolated from 78% of children younger than 15 years (28 of 36) compared with 25% of adults (16 of 64) (P = 0.0001). Isolation of a penicillin-nonsusceptible pneumococcus in adults with meningitis was independently associated with referral from another hospital (P = 0.005) and previous antibiotic therapy (P = 0.025). Multilocus sequence typing showed that 86% of the invasive penicillin-resistant pneumococcus isolates tested (12 of 14) were of the Spain(23F)-1 clone. The serotypes of >95% of the penicillin-nonsusceptible pneumococci were included in the currently available pneumococcal vaccines. Our findings point to the recent introduction and spread of the Spain(23F)-1 clone of penicillin-resistant pneumococci in Vietnam. Simple clinical predictors can be used to guide empirical antibiotic therapy of meningitis. Pneumococcal vaccination may help to control this problem. |
| spellingShingle | Parry, C Duong, N Zhou, J Mai, N Diep, T Thinh, L Wain, J Van Vinh Chau, N Griffiths, D Day, N White, N Hien, T Spratt, BG Farrar, J Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title | Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title_full | Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title_fullStr | Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title_full_unstemmed | Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title_short | Emergence in Vietnam of Streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant Spain(23F)-1 clone. |
| title_sort | emergence in vietnam of streptococcus pneumoniae resistant to multiple antimicrobial agents as a result of dissemination of the multiresistant spain 23f 1 clone |
| work_keys_str_mv | AT parryc emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT duongn emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT zhouj emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT main emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT diept emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT thinhl emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT wainj emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT vanvinhchaun emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT griffithsd emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT dayn emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT whiten emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT hient emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT sprattbg emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone AT farrarj emergenceinvietnamofstreptococcuspneumoniaeresistanttomultipleantimicrobialagentsasaresultofdisseminationofthemultiresistantspain23f1clone |