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SURVEY ON THE PREVALENCE OF MACROLIDE RESISTANCE GENES IN STREPTOCOCCUS PNEUMONIAE CAUSING COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN
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Abstract
Objective: Determine the prevalence of macrolide resistance genes (Mef(A/E) and Erm(B)) in Streptococcus pneumoniae causing community-acquired pneumonia in children in Ho Chi Minh City. Subjects and methods: A cross-sectional descriptive study was conducted from December 2021 to October 2022 on 36 strains of S. pneumoniae isolated from sputum sample of children aged ≤ 16 years diagnosed with community-acquired pneumonia and collected from Microbiology Laboratory, Nam Khoa Service and Trading Limited Liability Company. Antibiotic susceptibility testing and the presence of the resistance genes Mef(A/E) and Erm(B) were determined according to CLSI 2021 standards. Data analysis and processing were performed using STATA 14.0 software. Results: Among the total of 36 S. pneumoniae samples, 94.4% (34/36) carried erythromycin resistance genes. The proportion of samples carrying only the Erm(B) gene was 41.7%, those carrying only the Mef(A/E) gene was 30.5%, and those carrying both Erm(B) and Mef(A/E) genes simultaneously was 16.7%. The distribution of macrolide resistance genes indicated variations in resistance levels and resistance phenotypes among S. pneumoniae strains. Conclusions: S. pneumoniae causing community-acquired pneumonia in children in Ho Chi Minh City in 2022, exhibited a macrolide resistance rate of 94.4% with the Erm(B) gene playing a significant role in macrolide resistance, detected in 58.4% of clinical samples. The co-occurrence of Erm(B) and Mef(A/E) genes in 16.7% of samples suggests increasing complexity in macrolide resistance mechanisms in S. pneumoniae. This finding highlights the need for stricter surveillance in the use of macrolide antibiotics.
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Keywords
Streptococcus pneumoniae, community-acquired pneumonia, macrolide resistance genes, Erm(B); Mef(A/E)
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