CHANGES IN ANTIMICROBIAL SUSCEPTIBILITY OF STREPTOCOCCUS PNEUMONIAE 1999-2019 AT A NORTHEAST OHIO ACADEMIC MEDICAL CENTER FOLLOWING INTRODUCTION OF 7- AND 13-VALENT CONJUGATE PNEUMOCOCCAL VACCINES (ID 1048)
- Michael R. Jacobs, United States of America
- Michael R. Jacobs, United States of America
- Ayman M. Abdelhamed, United States of America
- Caryn E. Good, United States of America
- Saralee Bajaksouzian, United States of America
- Anne R. Windau, United States of America
- Daniel D. Rhoads, United States of America
Abstract
Background
Antimicrobial resistance has presented a major clinical challenge, with many resistant serotypes included in 7- and 13-valent conjugated vaccines (PCV7, PCV13, Prevnar, Pfizer) introduced in 200 and 2010, respectively.
Methods
This study compares antimicrobial susceptibility of key antimicrobials against pneumococcal isolates from all sources from the year prior to PCV7 introduction (1999), the period following use of PCV7 (2000-2009), the year of PCV13 introduction (2010), and the period since introduction of PCV13 (2011-2019).
Results
2,336 S. pneumoniae were isolated, 196 in 1999, 1,369 in 2000-2009, 68 in 2010 and 708 in 2011-2019 (Table). Over the study period, susceptibility increased for penicillin IV (52.0% to 66.2% at meningitis and 81.6% to 93.1% at nonmeningitis breakpoints), amoxicillin (71.9% to 93.5%), ceftriaxone IV (72.4% to 87.5% at meningitis and 93.9% to 98.1% at nonmeningitis breakpoints) and trimethoprim-sulfamethoxazole (54.6% to 79.6%), and decreased for clindamycin (94.9% to 86.1%). Azithromycin susceptibility initially decreased from 69.4% in 1999 to 47.9% in 2010, and then increased to 60.2% in 2017-2019. Levofloxacin susceptibility was high throughout.
Conclusions
Antimicrobial susceptibility of pneumococci to penicillin, amoxicillin, ceftriaxone and trimethoprim-sulfamethoxazole improved after introduction of conjugate vaccines, while susceptibility to azithromycin and clindamycin did not, with almost 40% of isolates resistant to azithromycin in 2017-2019.