Detection of Macrolide-Resistant Streptococcus pneumoniae Genes and Its Clinical Outcomes in a Tertiary Teaching Hospital in Malaysia.

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Malaysian Journal of Medical Sciences Pub Date : 2024-04-01 Epub Date: 2024-04-23 DOI:10.21315/mjms2024.31.2.17

Wan Norliyana Wan Mahmud, Siti Asma' Hassan, Zaidah Abd Rahman, Wan Nor Amilah Wan Abdul Wahab, Nabilah Ismail

{"title":"Detection of Macrolide-Resistant Streptococcus pneumoniae Genes and Its Clinical Outcomes in a Tertiary Teaching Hospital in Malaysia.","authors":"Wan Norliyana Wan Mahmud, Siti Asma' Hassan, Zaidah Abd Rahman, Wan Nor Amilah Wan Abdul Wahab, Nabilah Ismail","doi":"10.21315/mjms2024.31.2.17","DOIUrl":null,"url":null,"abstract":"Background: Streptococcus pneumoniae is one of the leading causes of mortality and morbidity worldwide. The dramatic increase in in-vitro resistance of antimicrobial agents, particularly beta-lactams and macrolides, makes pneumococcal infections difficult to treat. The aim of this study was to describe the drug resistance rate, assess the prevalence of macrolide-resistant genes and review the clinical complications of pneumococcal infections among patients presented to Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.Methods: This is a descriptive cross-sectional study. All S. pneumoniae isolates collected from clinical specimens within a 1-year period were subjected to selected antimicrobial susceptibility testing using E-test strips. Polymerase chain reaction (PCR) analysis was conducted to detect macrolide-resistant determinants. The patient's clinical data were obtained from clinical notes.Results: A total of 113 patients with a positive growth of S. pneumoniae were included in the study. The most common predisposing factors among them were bronchopulmonary diseases (15.9%). The penicillin-resistant rate was 7.1%, with minimal inhibitory concentration (MIC) ranging between 0.012 μg/mL and >32 μg/mL, and the erythromycin-resistant rate was 26.5%, with a MIC range of 0.03 μg/mL-> 256 μg/mL. Most of the erythromycin-resistant isolates were found to have the mef(A) gene (50.4%) and the erm(B) gene (20%); 16.7% had a combination of genes mef(A) and erm(B), and 13.3% had none of the two genes. Community-acquired pneumonia is the predominant type of pneumococcal infection. There was no significant association between the presence of macrolide resistance determinants and mortality (P = 0.837) or complications (P > 0.999 for empyema and cardiac complication; P = 0.135 for subdural abscess).Conclusion: The majority of erythromycin-resistant isolates were found to have the mef(A) gene, followed by the erm(B) gene and a combination of genes mef(A) and erm(B).","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057836/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Malaysian Journal of Medical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21315/mjms2024.31.2.17","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/23 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Streptococcus pneumoniae is one of the leading causes of mortality and morbidity worldwide. The dramatic increase in in-vitro resistance of antimicrobial agents, particularly beta-lactams and macrolides, makes pneumococcal infections difficult to treat. The aim of this study was to describe the drug resistance rate, assess the prevalence of macrolide-resistant genes and review the clinical complications of pneumococcal infections among patients presented to Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

Methods: This is a descriptive cross-sectional study. All S. pneumoniae isolates collected from clinical specimens within a 1-year period were subjected to selected antimicrobial susceptibility testing using E-test strips. Polymerase chain reaction (PCR) analysis was conducted to detect macrolide-resistant determinants. The patient's clinical data were obtained from clinical notes.

Results: A total of 113 patients with a positive growth of S. pneumoniae were included in the study. The most common predisposing factors among them were bronchopulmonary diseases (15.9%). The penicillin-resistant rate was 7.1%, with minimal inhibitory concentration (MIC) ranging between 0.012 μg/mL and >32 μg/mL, and the erythromycin-resistant rate was 26.5%, with a MIC range of 0.03 μg/mL-> 256 μg/mL. Most of the erythromycin-resistant isolates were found to have the mef(A) gene (50.4%) and the erm(B) gene (20%); 16.7% had a combination of genes mef(A) and erm(B), and 13.3% had none of the two genes. Community-acquired pneumonia is the predominant type of pneumococcal infection. There was no significant association between the presence of macrolide resistance determinants and mortality (P = 0.837) or complications (P > 0.999 for empyema and cardiac complication; P = 0.135 for subdural abscess).

Conclusion: The majority of erythromycin-resistant isolates were found to have the mef(A) gene, followed by the erm(B) gene and a combination of genes mef(A) and erm(B).

查看原文本刊更多论文

马来西亚一家三级教学医院中耐受大环内酯类药物的肺炎链球菌基因检测及其临床结果。

背景：肺炎链球菌是导致全球死亡和发病的主要原因之一。抗菌药物，尤其是β-内酰胺类和大环内酯类药物的体外耐药性急剧增加，使得肺炎球菌感染难以治疗。本研究旨在描述在马来西亚吉兰丹州马来西亚理科大学医院（HUSM）就诊的患者的耐药率，评估耐大环内酯类药物基因的流行情况，并回顾肺炎球菌感染的临床并发症：这是一项描述性横断面研究。在 1 年内从临床标本中收集的所有肺炎球菌分离物均使用 E 测试条进行了抗菌药敏感性测试。聚合酶链反应（PCR）分析用于检测耐大环内酯类药物的决定因素。患者的临床数据来自临床记录：研究共纳入了 113 名肺炎双球菌生长呈阳性的患者。其中最常见的致病因素是支气管肺部疾病（15.9%）。青霉素耐药率为 7.1%，最小抑菌浓度（MIC）范围为 0.012 μg/mL 至 >32 μg/mL，红霉素耐药率为 26.5%，MIC 范围为 0.03 μg/mL-> 256 μg/mL。大多数耐红霉素的分离株含有mef(A)基因（50.4%）和erm(B)基因（20%）；16.7%的分离株含有mef(A)和erm(B)基因，13.3%的分离株没有这两种基因。社区获得性肺炎是肺炎球菌感染的主要类型。大环内酯耐药基因的存在与死亡率（P = 0.837）或并发症（肺水肿和心脏并发症的 P > 0.999；硬膜下脓肿的 P = 0.135）之间无明显关联：结论：发现大多数耐红霉素的分离株具有mef（A）基因，其次是erm（B）基因，以及mef（A）和erm（B）基因的组合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Malaysian Journal of Medical Sciences MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access, fully online journal that is published at least six times a year. The journal’s scope encompasses all aspects of medical sciences including biomedical, allied health, clinical and social sciences. We accept high quality papers from basic to translational research especially from low & middle income countries, as classified by the United Nations & World Bank (https://datahelpdesk.worldbank.org/knowledgebase/ articles/906519), with the aim that published research will benefit back the bottom billion population from these countries. Manuscripts submitted from developed or high income countries to MJMS must contain data and information that will benefit the socio-health and bio-medical sciences of these low and middle income countries. The MJMS editorial board consists of internationally regarded clinicians and scientists from low and middle income countries.