Detection of serotypes and antimicrobial resistance genes of Streptococcus pneumoniae in clinical samples of patients with invasive disease in Paraguay
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Abstract
Introduction: Streptococcus Pneumoniae is the etiologic agent responsible for serious invasive diseases, such as community-acquired bacterial pneumonia, sepsis, and meningitis. It remains one of the most important causes of morbidity and mortality in children and adults worldwide. Data on serotypes and antimicrobial resistance profiles provide relevant information to inform treatment guidelines and vaccination policies.
Objectives: to detect serotypes and antimicrobial resistance genes in clinical samples from children and adults with invasive disease caused by Streptococcus pneumoniae in Paraguay during 2023.
Methods: this was a retrospective, cross-sectional and descriptive study. All clinical samples (N=145) from patients with invasive Streptococcus pneumoniae disease that were not isolated in bacteriological cultures from sentinel and collaborating centers were studied as part of meningitis and pneumonia surveillance in Paraguay during 2023.
Results: twenty serotypes were identified, the most frequent being serotype 3 in 56.5%, 19A in 11.0%, and 15A/15F in 4.1%. In serotype 3, the pbp2b gene was detected in 96.3% of cases, ermB in 18.3%, mefA in 6.1%, and tetMen in 74.4%; in serotype 19A, the pbp2b gene was detected in 12.5% of cases, ermB in 75.0%, mefA in 50.0%, and tetMen in 81.2%; in serotype 15A/15F, the pbp2b gene was detected in 83.3% of cases, ermB in 66.7%, mefA in 16.7%, and tetM in 83.3%.
Conclusion: a high percentage of pbp2b was detected, indicating high susceptibility to penicillin. However, high tetracycline resistance was also observed in serotype 3 and macrolide resistance in serotypes 19A and 15A/15F. Molecular techniques applied directly to clinical material have the potential to detect the infecting organism and determine its susceptibility to antimicrobials, thus facilitating timely therapy and intervention with appropriate antibiotics.
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