Nationwide surveillance of antimicrobial resistance in invasive isolates of Streptococcus pneumoniae in Taiwan from 2017 to 2019.

Abstract

BACKGROUND/PURPOSE:

Streptococcus pneumoniae causes pneumonia and other invasive diseases, and is a leading cause of mortality in the elderly population. The present study aimed to provide current antimicrobial resistance and epidemiological profiles of S. pneumoniae infections in Taiwan.

METHODS:

A total of 252 nonduplicate S. pneumoniae isolates were collected from patients admitted to 16 hospitals in Taiwan between January 2017 and December 2019, and were analyzed. The minimum inhibitory concentration of antibiotics was determined using the Vitek 2 automated system for antimicrobial susceptibility testing. Furthermore, epidemiological profiles of S. pneumoniae infections were analyzed.

RESULTS:

Among the strains analyzed, 88% were recognized as invasive pneumococcal strains. According to the Clinical and Laboratory Standards Institute criteria for non-meningitis, the prevalence of penicillin-non-susceptible S. pneumoniae demonstrated a declining trend from 43.6% in 2017 to 17.2% in 2019. However, the rate of penicillin-non-susceptible S. pneumoniae was 85.7% based on the criteria for meningitis. Furthermore, the prevalence of ceftriaxone-non-susceptible S. pneumoniae was 62.7% based on the criteria for meningitis. Isolates demonstrated higher susceptibility toward doripenem and ertapenem than toward meropenem and imipenem. An increased rate of non-susceptibility toward levofloxacin was observed in southern Taiwan (15.1%) and elderly patients (≥65 years; 11.4%). Most isolates were susceptible to vancomycin and linezolid.

CONCLUSION:

Empirical treatment with ceftriaxone monotherapy for pneumococcal meningitis should be carefully monitored owing to its high non-susceptibility rate. The susceptibility rates of most isolates to penicillin (used for treating non-meningitis pneumococcal diseases), carbapenems (ertapenem and doripenem), respiratory quinolones (moxifloxacin and levofloxacin), vancomycin, and linezolid suggested the potential of these antibiotics in treating pneumococcal diseases in Taiwan.

• Authors: Yu-Te Tsai, Yu-Lin Lee, Min-Chi Lu, Pei-Lan Shao, Po-Liang Lu, Shu-Hsing Cheng, Wen-Chien Ko, Chi-Ying Lin, Ting-Shu Wu, Muh-Yong Yen, Lih-Shinn Wang, Chang-Pan Liu, Wen-Sen Lee, Zhi-Yuan Shi, Yao-Shen Chen, Fu-Der Wang, Shu-Hui Tseng, Chao-Nan Lin, Yu-Hui Chen, Wang-Huei Sheng, Chun-Ming Lee, Hung-Jen Tang, Chun-Yu Lin, Yen-Hsu Chen, Po-Ren Hsueh
• Journal: Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (J Microbiol Immunol Infect) Vol. 55 Issue 2 Pg. 215-224 (Apr 2022) ISSN: 1995-9133 [Electronic] England
• PMID: 34219043 (Publication Type: Journal Article)
• Copyright: Copyright © 2021. Published by Elsevier B.V.

Chemical References

• Anti-Bacterial Agents
• Penicillins
• Levofloxacin
• Vancomycin
• Ceftriaxone
• Doripenem
• Ertapenem
• Linezolid

Topics

• Aged
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Ceftriaxone (pharmacology)
• Doripenem (therapeutic use)
• Drug Resistance, Bacterial
• Ertapenem (therapeutic use)
• Humans
• Levofloxacin (therapeutic use)
• Linezolid (therapeutic use)
• Meningitis, Pneumococcal (drug therapy)
• Microbial Sensitivity Tests
• Penicillins (pharmacology, therapeutic use)
• Pneumococcal Infections (drug therapy, epidemiology)
• Streptococcus pneumoniae
• Taiwan (epidemiology)
• Vancomycin (pharmacology)