New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains

New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains

Alternative title Novos pontos de corte de sensibilidade nas taxas de resistência antimicrobiana de cepas invasivas de pneumococo
Author Wolkers, Paula Carolina Bejo Google Scholar
Mantese, Orlando Cesar Autor UNIFESP Google Scholar
Paula, Alan de Google Scholar
Almeida, Vivieni Vieira Prado Google Scholar
Aguiar, Paula Augusta Dias Fogaca de Google Scholar
Alvares, Jackelline Rodrigues Autor UNIFESP Google Scholar
Almeida, Samanta Cristine Grassi Autor UNIFESP Google Scholar
Brandileone, Maria Cristina de Cunto Autor UNIFESP Google Scholar
Institution Universidade Federal de Uberlândia (UFU)
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
IAL
Abstract Objective: To evaluate the impact of new penicillin susceptibility breakpoints on resistance rates of pneumococcal strains collected from children with pneumonia.Methods: Pneumococcal strains collected from patients admitted with pneumonia were isolated at the clinical analysis lab of Hospital de Clinicas de Uberlandia, Uberlandia, Brazil, and sent to Instituto Adolfo Lutz, São Paulo, Brazil, for further identification, serotyping and determination of antimicrobial susceptibility.Results: From April 1999 to December 2008, 330 strains of pneumococcus were sent to Instituto Adolfo Lutz; of these, 195 (59%) were collected from patients with pneumonia. One hundred strains collected from patients <= 12 years old were analyzed. the patients' age ranged from 1 to 12.6 years old (with mean age of 2.4 and median of 1.7 years). Forty-seven patients were male. the strains were isolated from blood (42%) and pleural fluid (58%). There were 35 oxacillin-resistant strains: according to the criteria defined by the Clinical and Laboratory Standards Institute (CLSI) in 2007 [minimum inhibitory concentration (MIC) <= 0.06 mu g/mL for susceptibility (S), 0.12 to 1 mu g/mL for intermediate resistance (IR), and <= 2 mu g/mL for full resistance (FR)], 22 strains had IR and 11 strains had FR. According to the current breakpoints defined by the CLSI in 2008 (<= 2 mu g/mL for S, 4 mu g/mL for IR and >= 8 mu g/mL for FR), only one strain had IR to penicillin. There was resistance to co-trimoxazole (80%), tetracycline (21%), erythromycin (13%), clindamycin (13%), and ceftriaxone (one strain simultaneously resistant to penicillin).Conclusions: When the new breakpoints for in vitro susceptibility were applied, penicillin resistance rates dropped 97%, from 33 to 1%.
Keywords Pneumococcus
antimicrobial resistance
pneumonia
Language English
Date 2009-09-01
Published in Jornal de Pediatria. Rio de Janeiro, Rj: Soc Brasil Pediatria, v. 85, n. 5, p. 421-425, 2009.
ISSN 0021-7557 (Sherpa/Romeo, impact factor)
Publisher Soc Brasil Pediatria
Extent 421-425
Origin http://dx.doi.org/10.2223/JPED.1931
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000271570200009
SciELO ID S0021-75572009000500009 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/31763

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