Detección de serotipos y genes de resistencia antimicrobiana de Streptococcus pneumoniae en muestras clínicas de pacientes con enfermedad invasiva en Paraguay
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Introducción: Streptococcus pneumoniae es el agente etiológico responsable de enfermedades invasivas graves como neumonías bacterianas adquiridas en la comunidad, sepsis y meningitis. Sigue siendo una de las causas más importantes de morbilidad y mortalidad en niños y adultos alrededor del mundo. Los datos deserotipos y perfil de resistencia antimicrobiana proporcionaran información relevante para fundamentar las directrices de tratamiento y las políticas de vacunación.
Objetivos: detectar serotipos y genes de resistencia antimicrobiana en muestras clínicas de niños y adultos con enfermedad invasiva causada por Streptococcuspneumoniae en Paraguay en el año 2023.
Metodología: estudio descriptivo retrospectivo de corte transversal. Se estudiaron todas las muestras clínicas (n = 145) de pacientes con enfermedad invasiva por Streptococcus pneumoniaeque no fueron asiladas en cultivos bacteriológicos provenientes de los centros centinela y colaboradores en el marco de la vigilancia de meningitis y neumonías de Paraguay durante el año 2023.
Resultados: se identificaron 20 serotipos, siendo los más frecuentes el serotipo 3 en 56,5 %, el 19A en 11,0 % y el 15A/15F en 4,1 %. En el serotipo 3 se detectó el gen pbp2b en 96,3 %, ermB 18,3 %, mefA en 6,1 % y tetMen 74,4 %, en el serotipo 19A el gen pbp2b en 12,5 %, ermB en 75,0 %, mefA en 50,0 % y tetMen 81,2 %, el serotipo 15A/15F el gen pbp2b en 83,3 %, ermBen 66,7 %, mefA en 16,7 % y tetM en 83,3 %.
Conclusión: se detectó un alto porcentaje de pbp2b lo que indica una alta susceptibilidad a la penicilina, sin embargo, también se observó alta resistencia a tetraciclina relacionada con el serotipo 3 y resistencia a macrólidos relacionada a los serotipos 19A y 15A/15F. Técnicas moleculares aplicadas directamente al material clínico tienen el potencial de detectar el organismo infectante y determinar su susceptibilidad a los antimicrobianos, facilitando así la terapia oportuna e intervención con antibióticos adecuados.
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