Circulating Serotypes and Trends in Antibiotic Resistance of Invasive Streptococcus Pneumoniae from Children under Five in Bangalore

Abstract

Background: Globally, Streptococcus pneumoniae is estimated to be responsible for 1 to 2 million deaths annually, in extremes of age. Serotypic distribution of pneumococci varies with age, time, and geographical area. Limited data is available on serotypic prevalence and antimicrobial susceptibility patterns of pneumococci in India. Aim: To assess resistance trends to different groups of antimicrobials and serotypic prevalences of invasive pneumococci. Settings and Design: A prospective, hospital based study was conducted for two years, at a tertiary care medical college hospital in south Bangalore. Forty invasive pneumococcal isolates from children who were ≤5 years, with a clinical and radiological diagnosis of invasive pneumococcal disease, (IPD) were evaluated. Methods: Qualitative typing/grouping was performed by doing the capsular reaction test (Neufeld test). Antimicrobial susceptibility was tested by Minimum Inhibitory Concentration method using automated microdilution procedure. Results: The predominant invasive pneumococcal serotypes were serogroups/types (SGTs) 6 (25%) and 14 (17.5%). 35%, 77.5% and 15% of isolates were resistant to Penicillin, Trimethoprim/ Sulfamethoxazole (TMP-SMX) and Ceftriaxone respectively. Intermediate and high level resistances to penicillin were seen in 22.5% and 12.5% of S. pneumoniae isolates correspondingly. Multidrug resistance was observed in 20% of strains. Conclusion: This study reported presence of high level drug resistance in invasive pneumococcal isolates which were obtained from children. The serogroup/type distribution in our study and those in other Indian studies were not even. This calls for monitoring of resistance and mapping of serotype distribution.

Keywords

• streptococcus pneumoniae
• invasive pneumococcal disease
• serotypes
• drug resistance