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Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital

Year 2014, , 136 - 140, 01.12.2014
https://doi.org/10.5799/ahinjs.02.2014.04.0156

Abstract

Objective: There have been prominent changes in evaluation of resistance patterns of pneumococci and breakpoint values in recent years. We aimed to investigate the penicillin sensitivity of pneumococcal strains isolated from the ce­rebrospinal fluid specimens between the years 1997-2011 in our hospital and determine the MIC values under the light of these changes. Methods: Identification of pneumococci was made with conventional methods in patients with meningitis. MIC values for penicillin G were investigated by E test method in all strains. MIC values of pneumococci strains were evaluated ac­cording to values determined by CLSI for meningitis isolates in 2008. Results: A total of 57 strains were investigated in this study. The MIC range for penicillin was 0.016 - 0.75 μg/ml in S. pneumoniae strains. Seventy five percent of the strains were sensitive and eight strains (14%) had resistance. MIC50 value was sensitive, and a MIC90 value was resistant. The first resistant strain was detected in 2000, and three strains were resistant in the last year. When examined over the years increased resistance was 5.3% in the first five-year period seems to be 28.6% in the last five-year period. Conclusions: Knowledge on penicillin resistance patterns and surveillance is very important in the empirical treatment in pneumococcal meningitis.

References

  • Klugman KP. Pneumococcal resistance to antibiotics. Clin Mi- crobiol Rev 1990; 3: 171-196.
  • Cetron MS, Jernigan DB, Breiman RF. Action Plan for Drug- Resistant Streptococcus pneumoniae. Emerg Infect Dis 1995: 64-65.
  • The Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; 18th Infor- mational Supplement (M100-S18), CLSI, Wayne PA (2008).
  • WHO Report, Acute Respiratory Infections, 2009. Streptococ- cus pneumonia. Available from: URL: http://www.who.int/ vaccine_research/diseases/ari/en/index3.html
  • The Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; 17th Infor- mational Suplement (M100-S17), CLSI, Wayne PA (2007).
  • Firat M, Ersoy Y, Esel D, et al. Antimicrobial susceptibility and serotype distribution of pneumococci strains isolated from meningitis patients. Bull Microbiol 2006; 40: 169-177.
  • Tuncer I, Arslan U, Fındık D, Ural O. Increasing penicillin re- sistance and resistance to some other antibiotics in Strepto- coccus pneumonia strains isolated from clinical specimens. ANKEM Derg 2005; 19:35-38.
  • Yalcin I, Gurler N, Alhan E, et al. Serotype distribution and antibiotic susceptibility of invasive Streptococcus disease isolates from children in Turkey, 2001-2004. Eur J Pediatr 2006; 165: 654-657.
  • Uludag Altun H, Hascelik G, Gur D, Koseoglu Eser O. Inva- sive pneumococci before the introduction of pneumococcal conjugate vaccine in Turkey: antimicrobial susceptibility, se- rotype distribution, and molecular identification of macrolide resistance. J Chemother 2014 Doi: http://dx.doi.org/10.1179/ 1973947814Y.0000000176
  • Mudhune S, Wamae M. Report on invasive disease and meningitis due to Haemophilus influenzae and Streptococ- cus pneumonia from The Network for Surveillance of Pneu- mococcal diseases in the East African Region. Clin Infect Dis 2009; 48: 147-152.
  • Scheifele D, Halperin S, Pelletier L, et al. Reduced suscep- tibility to penicillin among pneumococci causing invasive in- fection in children – Canada, 1991 to 1998. Can J Infect Dis 2001; 12: 241-246.
  • Shah AS, Deloria Knoll M, Sharma PR, et al. Invasive pneu- mococcal disease in Kanti Children’s Hospital, Nepal, as ob- served by the South Asian Pneumococcal Alliance Network. Clin Infect Dis 2009; 48: 123-128.
  • Choi EH, Lee HJ. Clinical Outcome of Invasive Infections by Penicillin-Resistant Streptococcus pneumoniae in Korean Children. CID 1998; 26: 1346-1354.
  • Felmingham D, Reinert RR, Hirakata Y, Rodloff A. Increas- ing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveil- lance study, and comparative in vitro activity of the ketolide, telithromycin. J Antimicrob Chemother 2002; 50: 25-37.
  • Dias R, Louro D, Canic M. Antimicrobial Susceptibility of In- vasive Streptococcus pneumoniae Isolates in Portugal over an 11-Year Period. Antimicrob Agents Chemother 2006; 50: 2098-2105.
  • Alvares JR, Mantese OC, Paula A, et al. Prevalence of pneu- mococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis. Braz J Infec Dis 2011; 15: 22-27.

Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital

Year 2014, , 136 - 140, 01.12.2014
https://doi.org/10.5799/ahinjs.02.2014.04.0156

Abstract

Amaç: Son yıllarda pnömokok bakterilerine direncin değerlendirilmesinde ve eşik değerlerinde büyük değişimler meydana geldi. Bu değişimler ışığında hastanemizde 1997-2011 yıllarında beyin omurilik sıvısı (BOS) örneklerinden izole edilen pnömokok suşlarında penisilin duyarlılıklarındaki değişimin araştırılması amaçlandı.Yöntemler: Tümü menenjitli hastalardan izole edilen pnömokokların tanımlamaları konvansiyonel yöntemlerle yapıldı. Tüm suşlarda penisilin G için MİK değerleri E test yöntemiyle araştırıldı. 2008 yılından itibaren pnömokoklarda penisilin MİK sınır değerleri, CLSI rehberine göre BOS izolatlarında ≤0,06 μg/ml duyarlı ve ≥0,12 μg/ml dirençli olarak değiştirildi.Bulgular: Çalışmanın kapsadığı dönemde toplam 57 suş araştırmaya dahil edildi. S. pneumoniae suşlarında, penisilin için MİK aralığı 0,016-0,75 μg/ml arasında bulundu. Suşların %75’i duyarlı, sekizi (%14) dirençli olarak tespit edildi. MİK50 değeri duyarlı, MİK90 değeri ise dirençli olarak saptandı. İlk dirençli suş 2000 yılında saptanırken son yıl ise suşların üçü dirençli bulundu. Yıllar içinde direnç artışı irdelendiğinde ilk beş yıllık periyotta %5,3 iken son beş yıllık periyotta %28,6 olduğu görülmektedir.Sonuç: Pnömokok menenjitlerinde penisilin direncinin bilinmesi ve takip edilmesi ampirik tedavi açısından büyük önem taşımaktadır

References

  • Klugman KP. Pneumococcal resistance to antibiotics. Clin Mi- crobiol Rev 1990; 3: 171-196.
  • Cetron MS, Jernigan DB, Breiman RF. Action Plan for Drug- Resistant Streptococcus pneumoniae. Emerg Infect Dis 1995: 64-65.
  • The Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; 18th Infor- mational Supplement (M100-S18), CLSI, Wayne PA (2008).
  • WHO Report, Acute Respiratory Infections, 2009. Streptococ- cus pneumonia. Available from: URL: http://www.who.int/ vaccine_research/diseases/ari/en/index3.html
  • The Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; 17th Infor- mational Suplement (M100-S17), CLSI, Wayne PA (2007).
  • Firat M, Ersoy Y, Esel D, et al. Antimicrobial susceptibility and serotype distribution of pneumococci strains isolated from meningitis patients. Bull Microbiol 2006; 40: 169-177.
  • Tuncer I, Arslan U, Fındık D, Ural O. Increasing penicillin re- sistance and resistance to some other antibiotics in Strepto- coccus pneumonia strains isolated from clinical specimens. ANKEM Derg 2005; 19:35-38.
  • Yalcin I, Gurler N, Alhan E, et al. Serotype distribution and antibiotic susceptibility of invasive Streptococcus disease isolates from children in Turkey, 2001-2004. Eur J Pediatr 2006; 165: 654-657.
  • Uludag Altun H, Hascelik G, Gur D, Koseoglu Eser O. Inva- sive pneumococci before the introduction of pneumococcal conjugate vaccine in Turkey: antimicrobial susceptibility, se- rotype distribution, and molecular identification of macrolide resistance. J Chemother 2014 Doi: http://dx.doi.org/10.1179/ 1973947814Y.0000000176
  • Mudhune S, Wamae M. Report on invasive disease and meningitis due to Haemophilus influenzae and Streptococ- cus pneumonia from The Network for Surveillance of Pneu- mococcal diseases in the East African Region. Clin Infect Dis 2009; 48: 147-152.
  • Scheifele D, Halperin S, Pelletier L, et al. Reduced suscep- tibility to penicillin among pneumococci causing invasive in- fection in children – Canada, 1991 to 1998. Can J Infect Dis 2001; 12: 241-246.
  • Shah AS, Deloria Knoll M, Sharma PR, et al. Invasive pneu- mococcal disease in Kanti Children’s Hospital, Nepal, as ob- served by the South Asian Pneumococcal Alliance Network. Clin Infect Dis 2009; 48: 123-128.
  • Choi EH, Lee HJ. Clinical Outcome of Invasive Infections by Penicillin-Resistant Streptococcus pneumoniae in Korean Children. CID 1998; 26: 1346-1354.
  • Felmingham D, Reinert RR, Hirakata Y, Rodloff A. Increas- ing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveil- lance study, and comparative in vitro activity of the ketolide, telithromycin. J Antimicrob Chemother 2002; 50: 25-37.
  • Dias R, Louro D, Canic M. Antimicrobial Susceptibility of In- vasive Streptococcus pneumoniae Isolates in Portugal over an 11-Year Period. Antimicrob Agents Chemother 2006; 50: 2098-2105.
  • Alvares JR, Mantese OC, Paula A, et al. Prevalence of pneu- mococcal serotypes and resistance to antimicrobial agents in patients with meningitis: ten-year analysis. Braz J Infec Dis 2011; 15: 22-27.
There are 16 citations in total.

Details

Primary Language English
Journal Section ART
Authors

Filiz Pehlivanoglu This is me

Gonul Sengoz This is me

Gönül Şengöz This is me

Sevtap Gursoy This is me

Publication Date December 1, 2014
Published in Issue Year 2014

Cite

APA Pehlivanoglu, F., Sengoz, G., Şengöz, G., Gursoy, S. (2014). Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital. Journal of Microbiology and Infectious Diseases, 4(04), 136-140. https://doi.org/10.5799/ahinjs.02.2014.04.0156
AMA Pehlivanoglu F, Sengoz G, Şengöz G, Gursoy S. Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital. J Microbil Infect Dis. December 2014;4(04):136-140. doi:10.5799/ahinjs.02.2014.04.0156
Chicago Pehlivanoglu, Filiz, Gonul Sengoz, Gönül Şengöz, and Sevtap Gursoy. “Increasing Penicillin Resistance in Pneumococci Isolated from Cerebrospinal Fluid Samples: Fifteen-Year Experience from a Teaching Hospital”. Journal of Microbiology and Infectious Diseases 4, no. 04 (December 2014): 136-40. https://doi.org/10.5799/ahinjs.02.2014.04.0156.
EndNote Pehlivanoglu F, Sengoz G, Şengöz G, Gursoy S (December 1, 2014) Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital. Journal of Microbiology and Infectious Diseases 4 04 136–140.
IEEE F. Pehlivanoglu, G. Sengoz, G. Şengöz, and S. Gursoy, “Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital”, J Microbil Infect Dis, vol. 4, no. 04, pp. 136–140, 2014, doi: 10.5799/ahinjs.02.2014.04.0156.
ISNAD Pehlivanoglu, Filiz et al. “Increasing Penicillin Resistance in Pneumococci Isolated from Cerebrospinal Fluid Samples: Fifteen-Year Experience from a Teaching Hospital”. Journal of Microbiology and Infectious Diseases 4/04 (December 2014), 136-140. https://doi.org/10.5799/ahinjs.02.2014.04.0156.
JAMA Pehlivanoglu F, Sengoz G, Şengöz G, Gursoy S. Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital. J Microbil Infect Dis. 2014;4:136–140.
MLA Pehlivanoglu, Filiz et al. “Increasing Penicillin Resistance in Pneumococci Isolated from Cerebrospinal Fluid Samples: Fifteen-Year Experience from a Teaching Hospital”. Journal of Microbiology and Infectious Diseases, vol. 4, no. 04, 2014, pp. 136-40, doi:10.5799/ahinjs.02.2014.04.0156.
Vancouver Pehlivanoglu F, Sengoz G, Şengöz G, Gursoy S. Increasing penicillin resistance in pneumococci isolated from cerebrospinal fluid samples: Fifteen-year experience from a teaching hospital. J Microbil Infect Dis. 2014;4(04):136-40.