Dynamics of antimicrobial resistance of Streptococcus pneumoniae following PCV10 introduction in Brazil: Nationwide surveillance from 2007 to 2019. Issue 23 (27th May 2021)

• Record Type: Journal Article
• Authors: Brandileone, Maria-Cristina C.; Almeida, Samanta C.G.; Bokermann, Sergio; Minamisava, Ruth; Berezin, Eitan N.; Harrison, Lee H.; Andrade, Ana-Lucia
• Is Part Of: Vaccine. Volume 39:Issue 23(2021)
• Page Start: 3207
• Page End: 3215
• Publication Date: 2021-05-27
• Subjects: Streptococcus pneumoniae -- Invasive pneumococcal diseases -- Antimicrobial resistance -- Multidrug resistance -- Pneumococcal conjugate vaccine -- Pneumococcal serotypes -- PCV10; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.02.063
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: Brazil introduced 10-valent pneumococcal conjugate vaccine (PCV10) into its immunization program in 2010. We assessed antimicrobial susceptibility of Streptococcus pneumoniae (Spn) obtained from a national surveillance system for invasive pneumococcal diseases (IPD) before/after PCV10 introduction. Methods: Antimicrobial non-susceptible isolates were defined as intermediate or resistant. Minimum inhibitory concentrations (MICs) to penicillin and ceftriaxone were analyzed by year. Antimicrobial susceptibility rates were assessed for each three-year-period using the pre-PCV10-period as reference. Susceptibility of vaccine-types was evaluated for 2017–2019. Results: 11, 380 isolates were studied. Spn with penicillin ≥ 0.125 mg/L and ceftriaxone ≥ 1.0 mg/L decreased in the three-years after PCV10 introduction (2011–2013: penicillin, 28.1–22.5%; ceftriaxone, 11.3%-7.6%) versus pre-PCV10-years (2007–2009: penicillin, 33.8–38.1%; ceftriaxone, 17.2%-15.6%). After 2013, the proportion of Spn with those MICs to penicillin and ceftriaxone increased to 39.4% and 19.7% in 2019, respectively. Non-susceptibility to penicillin and ceftriaxone increased in 2014–2016, and again in 2017–2019 especially among children < 5 years with meningitis (penicillin, 53.9%; ceftriaxone, 28.0%); multidrug-resistance reached 25% in 2017–2019. Serotypes 19A, 6C and 23A were most associated with antimicrobial non-susceptibility. Conclusions: Antimicrobial non-susceptible Spn decreased in the three-years after vaccination but subsequently increased and was associated with non-PCV10-types. Antimicrobial susceptibility surveillance is fundamental for guiding antibiotic therapy policies.