Clinical and microbiological characteristics of community-acquired pneumonia associated with Streptococcus pneumoniae in adult patients in Mexico / Características clínicas y microbiológicas de la neumonía adquirida en la comunidad asociada con Streptococcus pneumoniae en pacientes adultos en México

The aim of this study was to assess the risk factors and clinical and microbiological characteristics of community-acquired pneumonia (CAP) in adult patients in Mexico. Streptococcus pneumoniae classified as the causative agent of CAP in adult patients and patients with invasive S. pneumoniae isolates presented to three tertiary teaching hospitals during the 15-year study period were selected. Serotyping and susceptibility testing were performed for all included isolates. Clinical and demographic data were recorded. A total of 96 patients infected with S. pneumoniae (71 with CAP, 25 with invasive disease) were included. The CAP group involved more males (74.6%) than the invasive disease group (p = 0.03). Head trauma was more common in the CAP group (21.1%) than in the invasive disease group (4.0%; p = 0.03). The most prevalent serotype was 19A, followed by serotypes 3 and 23F. After the introduction of the heptavalent conjugated pneumococcal vaccine (PCV7), the prevalence of included serotypes declined significantly; no such change was found after the introduction of the PCV13 vaccine, including in the prevalence of serotype 19A. Susceptibility to all antimicrobials tested except vancomycin declined over the study period. In conclusion, head trauma was the most common comorbidity in the CAP group. The most prevalent serotype was 19A. Decreased susceptibility to most antimicrobials tested was observed.

El objetivo de este estudio fue evaluar los factores de riesgo y las características clínicas y microbiológicas de la neumonía adquirida en la comunidad (NAC) en pacientes adultos en México. Se seleccionaron pacientes adultos con NAC con Streptococcus pneumoniae como agente causal y pacientes con aislamientos invasivos de S. pneumoniae que concurrieron a tres hospitales de enseñanza de tercer nivel durante el período de estudio de 15 anos (2000-2015). Se realizaron pruebas de serotipificación y sensibilidad con todos los aislados incluidos. Se colectaron los datos clínicos y demográficos. Se incluyeron en total 96 pacientes infectados con S. pneumoniae (71 con NAC y 25 con enfermedad invasiva). El grupo con NAC incluía más varones (74,6%) que el grupo de enfermedad invasiva (p = 0,03). El traumatismo craneoencefálico fue más frecuente en el grupo NAC (21,1%) queen el grupo con enfermedad invasiva (4,0%; p = 0,03). El serotipo más frecuente fue 19A, seguido de los serotipos 3 y 23F. Después de la introducción de la vacuna antineumocócica conjugada heptavalente (PCV7), la prevalencia de los serotipos incluidos en aquella disminuyó significativamente; no sucedió lo mismo después de la introducción de la PCV13, incluso en relación con la prevalencia del serotipo 19A. La sensibilidad a todos los antimicrobianos evaluados, excepto la vancomicina, disminuyó durante el período de estudio. En conclusión, el traumatismo craneoencefálico fue la comorbilidad más frecuente en el grupo con NAC. El serotipo más frecuente fue el 19A, y se observó disminución de la sensibilidad a la mayoría de los antimicrobianos probados a lo largo del período considerado.

Non-vaccine Pneumococcal Serotypes Among Children with Invasive Pneumococcal Disease

Objective: To report the percentage of non-vaccine pneumococcal serotypes and theirantibiotic susceptibility pattern in children with invasive peumococcal disease. Methods:Invasive pneumococcal isolates of children <5 years during January 2007 to December2016 were serotyped by a co-agglutination reaction and sequential multiplex polymerasechain reaction. Results: Among the total 170 S. pneumoniae invasiveisolates, 54 (31.8%)and 44 (25.9 %) were the serotypes, which are not included in current 10-valent or 13-valent vaccines, respectively. Very low resistance was observed against penicillin (4.5%)and all isolates were susceptible to cefotaxime. Conclusions: One-fourth to one-third ofthe S. pneumoniae serotypes in under-five children with invasive pneumococcal diseaseare not covered by existing pneumococcal vaccines in India.

Performance evaluation of the GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcuspneumoniae on VITEK 2-Compact system / 中国感染与化疗杂志

Objective To evaluate the performance of GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcus pneumoniae on VITEK 2-Compact system,taking E-test as reference.Methods A total of 98 strains of S.pneumoniae were collected and subjected to susceptibility testing using E-test and VITEK 2-Compact (AST-GP68) in Luzhou People's Hospital form January 1 to December 31,2015.Results According to the breakpoints of Clinical and Laboratory Standards Institute (CLSI),category agreement (CA) of penicillin was 80.6％.Very major error (VME) was 0.Major error (ME) was 12.2％,minor error (mE) was 7.1％.CA of ceffriaxone was 90.8％,VME 0,ME 4.1％,mE 5.1％.CA of cefotaxime was 91.8％,VME 0,mE 5.1％,mE 3.1％.CA of meropenem was 85.7％,VME 0,ME 2.0％,mE 12.2％.CA of other antibiotics (amoxicillin,ertapenem,erythromycin,tetracycline,chloramphenicol,telithromycin,linezolid,vancomycin,moxifloxacin,ofloxacin,levofloxacin) was 100％.Conclusions AST-GP68 on VITEK 2-Compact system may have false results of antimicrobial resistance to some antibiotics such as penicillin,ceftriaxone,cefepime,meropenem due to the defects of the underlying principle.Such false results should be verified by other methods in clinical practice.