AUTHOR=Tran-Quang Khai , Nguyen-Thi-Dieu Thuy , Tran-Do Hung , Pham-Hung Van , Nguyen-Vu Trung , Tran-Xuan Bach , Larsson Mattias , Duong-Quy Sy 

TITLE=Antibiotic resistance of Streptococcus pneumoniae in Vietnamese children with severe pneumonia: a cross-sectional study

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1110903

DOI=10.3389/fpubh.2023.1110903

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p><italic>Streptococcus pneumoniae</italic> is the most common bacterium that causes community-acquired pneumonia (CAP) in children. The rate of <italic>S. pneumoniae</italic> resistance to antibiotics is increasing, particularly in patients with severe CAP. Therefore, the level of antibiotic resistance of <italic>S. pneumoniae</italic> causing severe CAP in Vietnamese children requires regular monitoring.</p></sec><sec><title>Methods</title><p>This was a cross-sectional descriptive study. Nasopharyngeal aspiration specimens from children were cultured, isolated, and examined for <italic>S. pneumoniae</italic>. Bacterial strains were assessed for antimicrobial susceptibility, and the minimum inhibitory concentration (MIC) was determined.</p></sec><sec><title>Results</title><p>Eighty-nine strains of <italic>S. pneumoniae</italic> were isolated from 239 children with severe CAP. The majority of isolates were completely non-susceptible to penicillin (1.1% intermediate, 98.9% resistant) and highly resistant to erythromycin (96.6%) and clarithromycin (88.8%); the rate of resistance to ceftriaxone was 16.9%, with the proportion of intermediate resistance at 46.0%; 100% of strains were susceptible to vancomycin and linezolid. For most antibiotics, MIC<sub>50</sub> and MIC<sub>90</sub> were equal to the resistance threshold according to the Clinical and Laboratory Standards Institute 2021; penicillin had an eight-fold increase in MIC<sub>90</sub> (64 mg/L) and ceftriaxone had a 1.5-fold increase in MIC<sub>90</sub> (6 mg/L).</p></sec><sec><title>Conclusion</title><p><italic>Streptococcus pneumoniae</italic> isolates described in this study were resistant to many antibiotics. Penicillin should not be the first-line antibiotic of choice, and ceftriaxone at an enhanced dose should be used instead.</p></sec>