1183. Serotype Prevalence and Antimicrobial Resistance Patterns of Streptococcus pneumoniae in Ecuador

Abstract

Abstract Background Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in the world, and it is under-researched in Ecuador. Reported mortality in this country was 280 cases per year. The national policy of the country established the obligatory application of the pneumococcal vaccine to infants in 2010, but there is no such law for adults. The serotypes' distribution and resistance patterns are unknown. This study aims to describe the serotypes and resistance patterns of Strepcococcus pneumoniae isolations in Ecuador. Methods A retrospective study of all positive cultures for Streptococcus pneumoniae (blood, other sterile liquids, respiratory, ocular, and ear samples) was conducted in three hospitals and one reference laboratory in Ecuador. Serotype data, E-test results for penicillin and ceftriaxone, resistance patterns and susceptibility to other antibiotics by the Kirby-Bauer test were collected. Results A total of 214 samples were evaluated: 18.8% (39) were tracheal secretions, 36.7% (76) sputum, 5.7% (11) cerebrospinal fluid, 17.4% (36) blood, 2.9% (6) pleural fluid, and 27.9% (37) others: ocular, abdominal, and ear secretions. A wide distribution of serotypes was observed. The most prevalent were 19A, 14 and 3. Figure 1 shows penicillin resistance increased per year. However, 93,3% (166) of the strains were ceftriaxone susceptible and 100% of the isolates tested showed susceptibility to vancomycin. Susceptibility to levofloxacin was 99.2%; only one isolate was resistant. No microorganism tested for linezolide was resistant. For other antibiotics, a high level of resistance was identified; 69.3% (54) for trimethoprim sulfamethoxazole, 47.5% (107) for erythromycin and 37.6% (104) for clindamycin. Figure 1.S. pneumoniae penicillin susceptibility percet by year in Ecuador Conclusion It is important to know the resistance patterns and serotypes of S. pneumoniae for therapeutic and epidemiologic decisions. In countries with more than 12% ceftriaxone resistance to Streptococcus pneumoniae, it is suggested for use as an empiric vancomicyn. Nowadays, in Ecuador, the resistance patterns don’t apply to extended vancomycin use. We do not recommend the empirical use of trimethoprim sulfamethoxazole, macrolides and clindamycin for S. pneumoniae infections. Disclosures All Authors: No reported disclosures.