Antimicrobial Susceptibility Pattern and Serotype Distribution of Streptococcus pneumoniae Isolates From a Hospital-Based Study in Chandigarh, North India.

Swati Sharma,Pallab Ray,Anuradha Chakraborti,Monica Sharma

doi:10.7759/cureus.21437

Abstract

Streptococcus pneumoniae (pneumococcus) causes significant infection-related morbidity and mortality worldwide. The genome plasticity of pneumococcus is an essential factor in antibiotic resistance, serotype switching, and the emergence of nonvaccine serotypes. Information regarding the serotype distribution as well as antimicrobial susceptibility in pneumococcus clinical isolates responsible for various infections in Northern India is limited. Here, we have explored the antibiotic resistance and serotype pattern associated with S. pneumoniae infections from both invasive and noninvasive sites of patients of all ages, visiting out-patient department of a tertiary care hospital (PGIMER, Chandigarh, India). This study was carried out on 68 S. pneumoniae isolates and the isolates exhibited the highest resistance (76.5%) to cotrimaxozole followed by resistance toward tetracycline (36.8%) and erythromycin (23.5%). All isolates showed vancomycin susceptibility and 86.8% of isolates showed sensitivity to chloramphenicol. Multidrug resistance was found in 32% (n=22) of the S. pneumoniae isolates showing resistance toward three different antibiotics. Serotype 19F was found to be the most prevalent serotype (39%) followed by serotypes 6A/B/C (19%) and 1 (12%). These data shed light on the latest trends in antibiotic susceptibility and prevalent serotype patterns of hospital-based S. pneumoniae isolates. This information can be helpful in designing future disease-preventive strategies.

Highlights

Streptococcus pneumoniae is responsible for causing various invasive as well as noninvasive diseases like pneumonia, bacteremia, otitis media, sepsis, and meningitis [1]
Clinical strains from blood, cerebrospinal fluid (CSF), sputum, and nasopharynx were isolated from lower respiratory tract infection patients
The presence of S. pneumoniae was confirmed into all the samples via the Bacteriology unit of Department of Medical Microbiology, PGIMER Hospital, Chandigarh (Union Territory), a tertiary care center catering to the population of union territory and nearby states, and after that, those samples were collected from the Bacteriology unit of Department of Medical Microbiology

Summary

Introduction

Streptococcus pneumoniae is responsible for causing various invasive as well as noninvasive diseases like pneumonia, bacteremia, otitis media, sepsis, and meningitis [1]. Infections caused by pneumococcus are responsible for significant morbidity and mortality worldwide. According to an SRMGBD (2016) study by Troeger C (2018) [2], Streptococcus pneumoniae was responsible for 1,189,937 deaths with 95% uncertainty index (690 ,445-1,770, 660). Most of the pneumococcal-related cases are reported from Asia and Africa, in which India accounts for 27% of the cases [3]. In India, the number of deaths associated with pneumococcal infections is estimated to be around 68,700 (an uncertainty range of 44,600-86,000) [4]. Emerging drug resistance in the case of pneumococcus is a serious problem that is responsible for the increased incidence of the novel, nonvaccine serotype, and multidrug-resistant strains

Methods

Results

Discussion

Conclusion