Drug-resistant Streptococcus pneumoniae

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Drug-resistant Streptococcus pneumoniae
Other names: Penicillin-resistant Streptococcus pneumoniae[1]
  • Top:Mechanisms of antibiotic resistance in Streptococcus pneumoniae.[2]

  • Bottom:Drug-resistant, Streptococcus pneumoniae bacteria[3]
SpecialtyInfectious disease
SymptomsSymptoms depend(DRSP can cause pneumonia, meningitis, or bloodstream infections)[4]
CausesS. pneumoniae[5]
Risk factorsRepeated exposure to antibiotics[5]
under 2 years and adults over 65 years
co-morbidity(heart, lung, liver, or kidney disease)
Diagnostic methodCulture and sensitivity testing[6]
PreventionVaccination[7]
TreatmentSpecific antibiotic selection[8]

Drug-resistant Streptococcus pneumoniae is a type of bacteria and a public health concern. It is a type of pneumococcus, which can result in pneumonia, meningitis, and bloodstream infections. Some strains have developed resistance to antibiotics, making treatment more challenging. [6][9][10]

Prevention is by vaccination.[6][9][10]

Global prevalence of drug-resistant Streptococcus pneumoniae is 1.3 percent[11]

Signs and symptoms

As to the signs and symptoms of drug-resistant Streptococcus pneumoniae we find it can cause various infections,therefore the symptoms depend on affected area of the body. In other words in pneumonia we see: [4]

Risk factor

Among the risk factors associated with acquiring DSSP we find:[5]

  • Underlying health conditions such as chronic illness, immunosuppression, recent respiratory infections
  • Frequent use of antibiotics can lead to resistance
  • Prolonged hospital stays, are associated with higher risk.
  • Young children and older adults are more susceptible.

Mechanism

Horizontal gene transfer[12]

In terms of the mechanism of DRSP we find that resistance happens via several stages. We find that genetic variability happens because the bacterium exhibits high genetic diversity, due to horizontal gene transfer and natural transformation. [13][14][15]

The bacteria's capsule, has over 90 serotypes, this helps it evade the immune system. Resistance genes are carried on plasmids(or transposons), which can be transferred between bacteria. Efflux pumps expel antibiotics from the bacterial cell, reducing drug efficacy.[13][14][15]

Diagnosis

In terms of the evaluation we find that diagnosing drug-resistant Streptococcus pneumoniae involves laboratory testing:[16][6]

  • Sample is taken from a sterile site(blood, cerebrospinal fluid, or pleural fluid)
  • Bacteria are isolated and identified.
  • Antibiotic susceptibility tests determine resistance levels(MIC)

Differential diagnosis

Klebsiella pneumoniae

We find that the DDx in DRSP is as follows:[17][18]

Prevention

In terms of prevention Pneumococcal conjugate vaccines are effective in preventing infections caused by resistant strains. Vaccines like PCV13 and PCV20 have significantly reduced resistant infections in both children and adults[19]

Treatment

Visual depiction of broad- and narrow-spectrum antibiotics[20]

As to the management of drug-resistant Streptococcus pneumoniae we find that antibiotic selection for treatment starts with broad-spectrum antibiotics. when the specific resistance profile of bacteria is identified, the individual may switch to more targeted antibiotic[8]

Prognosis

The prognosis of DRSP depends upon a variety of factors including the severity of infection, the individuals overall health, and the effectiveness of treatment.However, even with successful treatment, some survivors of pneumococcal infections,in particular meningitis, experience long-term neurological sequelae. [5]

Epidemiology

As to the epidemiology of DRSP we find it is responsible for a proportion of pneumococcal infections worldwide. In the U.S., a significant percentage of S. pneumoniae infections are resistant to one antibiotic.Penicillin resistance was first reported in the later half of the 20th century and has spread rapidly worldwide, with reports from Australia, South Africa, and other countries in Asia, and Europe.[21][22][11]

History

As to history we find that researchers have identified genetic mutations and mechanisms that contribute to antibiotic resistance in this bacterium. For example, scientists at the University of Sheffield in 2023 uncovered an evolutionary gateway that helps Streptococcus pneumoniae become resistant to antibiotics[23][24]

See also

References

  1. ↑ Ishikawa, Kazuhiro; Matsuo, Takahiro; Suzuki, Takahiro; Kawai, Fujimi; Uehara, Yuki; Mori, Nobuyoshi (1 May 2022). "Penicillin- and third-generation cephalosporin-resistant strains of Streptococcus pneumoniae meningitis: Case report and literature review". Journal of Infection and Chemotherapy. 28 (5): 663–668. doi:10.1016/j.jiac.2022.01.021. ISSN 1341-321X. Retrieved 24 March 2025.
  2. ↑ Rajput, Pratiksing; Nahar, Kazi S.; Rahman, Khondaker Miraz (8 December 2024). "Evaluation of Antibiotic Resistance Mechanisms in Gram-Positive Bacteria". Antibiotics (Basel, Switzerland). 13 (12): 1197. doi:10.3390/antibiotics13121197. ISSN 2079-6382.
  3. ↑ "Details - Public Health Image Library(PHIL)". phil.cdc.gov.
  4. ↑ 4.0 4.1 "Pneumococcal Disease Symptoms and Complications". Pneumococcal Disease. 12 April 2024. Archived from the original on 6 March 2025. Retrieved 28 March 2025.
  5. ↑ 5.0 5.1 5.2 5.3 Cillóniz, Catia; Garcia-Vidal, Carolina; Ceccato, Adrian; Torres, Antoni (2018). "Antimicrobial Resistance Among Streptococcus pneumoniae". Antimicrobial Resistance in the 21st Century. Springer International Publishing: 13–38. doi:10.1007/978-3-319-78538-7_2. Archived from the original on 2025-02-02. Retrieved 2025-03-25.
  6. ↑ 6.0 6.1 6.2 6.3 "Antibiotic-resistant Streptococcus pneumoniae". Pneumococcal Disease. 21 January 2025. Archived from the original on 20 March 2025. Retrieved 26 March 2025.
  7. ↑ Mohanty, Salini; Feemster, Kristen; Yu, Kalvin C; Watts, Janet A; Gupta, Vikas (1 March 2023). "Trends in Streptococcus pneumoniae Antimicrobial Resistance in US Children: A Multicenter Evaluation". Open Forum Infectious Diseases. 10 (3): ofad098. doi:10.1093/ofid/ofad098. ISSN 2328-8957.
  8. ↑ 8.0 8.1 Jacobs, M. R. (July 1992). "Treatment and diagnosis of infections caused by drug-resistant Streptococcus pneumoniae". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 15 (1): 119–127. doi:10.1093/clinids/15.1.119. ISSN 1058-4838. Archived from the original on 2025-02-02. Retrieved 2025-03-28.
  9. ↑ 9.0 9.1 "WHO updates list of drug-resistant bacteria most threatening to human health". www.who.int. Archived from the original on 12 March 2025. Retrieved 24 March 2025.
  10. ↑ 10.0 10.1 "DRUG-RESISTANT STREPTOCOCCUS PNEUMONIAE" (PDF). cdc. Retrieved 24 March 2025.
  11. ↑ 11.0 11.1 Aliberti, S.; Cook, G. S.; Babu, B. L.; Reyes, L. F.; Rodriguez, A. H.; Sanz, F.; et al. (2019). "International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia". The Journal of infection. doi:10.1016/j.jinf.2019.07.004. PMID 31299410. Archived from the original on 23 April 2024. Retrieved 1 April 2025.
  12. ↑ Bello-López, J. Manuel; Cabrero-Martínez, Omar A.; Ibáñez-Cervantes, Gabriela; Hernández-Cortez, Cecilia; Pelcastre-Rodríguez, Leda I.; Gonzalez-Avila, Luis U.; Castro-Escarpulli, Graciela (18 September 2019). "Horizontal Gene Transfer and Its Association with Antibiotic Resistance in the Genus Aeromonas spp". Microorganisms. 7 (9): 363. doi:10.3390/microorganisms7090363. ISSN 2076-2607.
  13. ↑ 13.0 13.1 Charpentier, E.; Tuomanen, E. (December 2000). "Mechanisms of antibiotic resistance and tolerance in Streptococcus pneumoniae". Microbes and Infection. 2 (15): 1855–1864. doi:10.1016/s1286-4579(00)01345-9. ISSN 1286-4579. Archived from the original on 2025-02-01. Retrieved 2025-03-27.
  14. ↑ 14.0 14.1 Li, Lifeng; Ma, Jiayue; Yu, Zengyuan; Li, Mingchao; Zhang, Wancun; Sun, Huiqing (January 2023). "Epidemiological characteristics and antibiotic resistance mechanisms of Streptococcus pneumoniae: An updated review". Microbiological Research. 266: 127221. doi:10.1016/j.micres.2022.127221. ISSN 1618-0623.
  15. ↑ 15.0 15.1 Cherazard, Regine; Epstein, Marcia; Doan, Thien-Ly; Salim, Tanzila; Bharti, Sheena; Smith, Miriam A. (May 2017). "Antimicrobial Resistant Streptococcus pneumoniae: Prevalence, Mechanisms, and Clinical Implications". American Journal of Therapeutics. 24 (3): e361. doi:10.1097/MJT.0000000000000551. ISSN 1075-2765. Retrieved 27 March 2025.
  16. ↑ "Streptococcus Pneumoniae, Drug-resistant Invasive Disease (DRSP) (Streptococcus pneumoniae) 2007 Case Definition | CDC". cdc. 29 July 2022. Retrieved 26 March 2025.
  17. ↑ "Pneumococcal Infections (Streptococcus pneumoniae) Differential Diagnoses". emedicine.medscape.com. Retrieved 26 March 2025.
  18. ↑ Dion, Christopher F.; Ashurst, John V. (2025). "Streptococcus pneumoniae". StatPearls. StatPearls Publishing. Archived from the original on 2022-10-22. Retrieved 2025-03-30.
  19. ↑ "Pneumococcal Conjugate Vaccine (Interim) VIS". Vaccines & Immunizations. 15 January 2025. Archived from the original on 6 March 2025. Retrieved 30 March 2025.
  20. ↑ Pancu, Daniel Florin; Scurtu, Alexandra; Macasoi, Ioana Gabriela; Marti, Daniela; Mioc, Marius; Soica, Codruta; Coricovac, Dorina; Horhat, Delia; Poenaru, Marioara; Dehelean, Cristina (7 April 2021). "Antibiotics: Conventional Therapy and Natural Compounds with Antibacterial Activity—A Pharmaco-Toxicological Screening". Antibiotics. 10 (4): 401. doi:10.3390/antibiotics10040401. PMC 8067816. PMID 33917092.
  21. ↑ Mohanty, Salini; Feemster, Kristen; Yu, Kalvin C.; Watts, Janet A.; Gupta, Vikas (March 2023). "Trends in Streptococcus pneumoniae Antimicrobial Resistance in US Children: A Multicenter Evaluation". Open Forum Infectious Diseases. 10 (3): ofad098. doi:10.1093/ofid/ofad098. ISSN 2328-8957. Archived from the original on 2023-03-29. Retrieved 2025-04-01.
  22. ↑ Appelbaum, P. C. (July 1992). "Antimicrobial resistance in Streptococcus pneumoniae: an overview". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 15 (1): 77–83. doi:10.1093/clinids/15.1.77. ISSN 1058-4838. Retrieved 29 March 2025.
  23. ↑ Kobras, Carolin M.; Monteith, William; Somerville, Sophie; Delaney, James M.; Khan, Imran; Brimble, Camilla; Corrigan, Rebecca M.; Sheppard, Samuel K.; Fenton, Andrew K. (10 October 2023). "Loss of Pde1 function acts as an evolutionary gateway to penicillin resistance in Streptococcus pneumoniae". Proceedings of the National Academy of Sciences. 120 (41): e2308029120. doi:10.1073/pnas.2308029120. Archived from the original on 22 December 2024. Retrieved 28 March 2025.
  24. ↑ Sheffield, University of. "Scientists identify evolutionary gateway helping pneumonia bacteria become resistant to antibiotics". phys.org. Retrieved 28 March 2025.
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