Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study.
Antimicrobial resistance in Streptococcus pneumoniae remains a serious concern worldwide, particularly in Asian countries, despite the introduction of heptavalent pneumococcal conjugate vaccine (PCV7). The Asian Network for Surveillance of Resistant Pathogens (ANSORP) performed a prospective surveillance study of 2,184 S. pneumoniae isolates collected from patients with pneumococcal infections from 60 hospitals in 11 Asian countries from 2008 to 2009. Among nonmeningeal isolates, the prevalence rate of penicillin-nonsusceptible pneumococci (MIC, ≥ 4 μg/ml) was 4.6% and penicillin resistance (MIC, ≥ 8 μg/ml) was extremely rare (0.7%). Resistance to erythromycin was very prevalent in the region (72.7%); the highest rates were in China (96.4%), Taiwan (84.9%), and Vietnam (80.7%). Multidrug resistance (MDR) was observed in 59.3% of isolates from Asian countries. Major serotypes were 19F (23.5%), 23F (10.0%), 19A (8.2%), 14 (7.3%), and 6B (7.3%). Overall, 52.5% of isolates showed PCV7 serotypes, ranging from 16.1% in Philippines to 75.1% in Vietnam. Serotypes 19A (8.2%), 3 (6.2%), and 6A (4.2%) were the most prominent non-PCV7 serotypes in the Asian region. Among isolates with serotype 19A, 86.0% and 79.8% showed erythromycin resistance and MDR, respectively. The most remarkable findings about the epidemiology of S. pneumoniae in Asian countries after the introduction of PCV7 were the high prevalence of macrolide resistance and MDR and distinctive increases in serotype 19A.
Asia Pacific Foundation for Infectious Diseases, Seoul, South Korea.
So Hyun
SH
Kim
Jae-Hoon
JH
Song
Doo Ryeon
DR
Chung
Visanu
V
Thamlikitkul
Yonghong
Y
Yang
Hui
H
Wang
Min
M
Lu
Thomas Man-Kit
TM
So
Po-Ren
PR
Hsueh
Rohani M
RM
Yasin
Celia C
CC
Carlos
Hung Van
HV
Pham
M K
MK
Lalitha
Nobuyuki
N
Shimono
Jennifer
J
Perera
Atef M
AM
Shibl
Jin Yang
JY
Baek
Cheol-In
CI
Kang
Kwan Soo
KS
Ko
Kyong Ran
KR
Peck
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001208:Asia; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D011446:Prospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014611:Vaccination
D000900:Anti-Bacterial Agents; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines