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Increase of Macrolide-Resistance in Streptococcus pneumoniae Strains After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in Lima, Peru.
Gonzales, Brayan E; Mercado, Erik H; Pinedo-Bardales, Maria; Hinostroza, Noemi; Campos, Francisco; Chaparro, Eduardo; Del Águila, Olguita; Castillo, María E; Saenz, Andrés; Reyes, Isabel; Ochoa, Theresa J.
  • Gonzales BE; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Mercado EH; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Pinedo-Bardales M; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Hinostroza N; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Campos F; Departamento de Pediatría, Hospital Nacional Docente Madre-Niño San Bartolomé, Lima, Peru.
  • Chaparro E; Departamento de Pediatría, Hospital Nacional Cayetano Heredia, Lima, Peru.
  • Del Águila O; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Castillo ME; Servicio de Pediatría de Especialidades Clínicas, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
  • Saenz A; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Reyes I; Oficina de Epidemiología, Instituto Nacional de Salud del Niño, Lima, Peru.
  • Ochoa TJ; Departamento de Pediatría, Hospital Nacional Daniel Alcides Carrión, Lima, Peru.
Front Cell Infect Microbiol ; 12: 866186, 2022.
Article in English | MEDLINE | ID: covidwho-1865449
ABSTRACT
Streptococcus pneumoniae upper respiratory infections and pneumonia are often treated with macrolides, but recently macrolide resistance is becoming an increasingly important problem. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the National Immunization Program of Peru in 2015. This study aimed to evaluate the temporal evolution of macrolide resistance in S. pneumoniae isolates collected in five cross-sectional studies conducted before and after this vaccine introduction, from 2006 to 2019 in Lima, Peru. A total of 521 and 242 S. pneumoniae isolates recovered from nasopharyngeal swabs from healthy carrier children < 2 years old (2 carriage studies) and samples from normally sterile body areas from pediatric patients with invasive pneumococcal disease (IPD) (3 IPD studies), respectively, were included in this study. Phenotypic macrolide resistance was detected using the Kirby-Bauer method and/or MIC test. We found a significant increase in macrolide resistance over time, from 33.5% to 50.0% in carriage studies, and from 24.8% to 37.5% and 70.8% in IPD studies. Macrolide resistance genes [erm(B) and mef(A/E)] were screened using PCR. In carriage studies, we detected a significant decrease in the frequency of mef(A/E) genes among macrolide-resistant S. pneumoniae strains (from 66.7% to 50.0%) after introduction of PCV13. The most common mechanism of macrolide-resistant among IPD strains was the presence of erm(B) (96.0%, 95.2% and 85.1% in the 3 IPD studies respectively). Macrolide resistance was more common in serotype 19A strains (80% and 90% among carriage and IPD strains, respectively) vs. non-serotype 19A (35.5% and 34.4% among carriage and IPD strains, respectively). In conclusion, S. pneumoniae macrolide resistance rates are very high among Peruvian children. Future studies are needed in order to evaluate macrolide resistance trends among pneumococcal strains, especially now after the COVID-19 pandemic, since azithromycin was vastly used as empiric treatment of COVID-19 in Peru.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumococcal Infections / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Topics: Vaccines Limits: Child / Child, preschool / Humans / Infant Country/Region as subject: South America / Peru Language: English Journal: Front Cell Infect Microbiol Year: 2022 Document Type: Article Affiliation country: Fcimb.2022.866186

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumococcal Infections / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Topics: Vaccines Limits: Child / Child, preschool / Humans / Infant Country/Region as subject: South America / Peru Language: English Journal: Front Cell Infect Microbiol Year: 2022 Document Type: Article Affiliation country: Fcimb.2022.866186