037 - TRENDS IN ANTIMICROBIAL SUSCEPTIBILITY OF STREPTOCOCCUS PNEUMONIAE ISOLATES AMONG CHILDREN UNDER-FIVE YEARS ADMITTED WITH BACTERIAL MENINGITIS DURING PNEUMOCOCCAL CONJUGATE VACCINE ERA IN YAOUNDÉ, CAMEROON. (ID 716)
Abstract
Background
The 13-valent pneumococcal conjugate vaccine (PCV-13) containing the multi-drug resistant serotype 19A and serotypes 1 and 5 frequently associated with bacterial meningitis (BM) epidemics across the African meningitis belt was introduced in Cameroon. We compared antimicrobial susceptibility in pneumococcal meningitis (PM) isolates following PCV13 implementation.
Methods
A total of 12762 cerebrospinal fluid (CSF) specimens were obtained from children admitted with clinically suspected bacterial meningitis (CSMB) at the sentinel surveillance sites in Yaoundé in 2003 – 2010 (pre-PCV13 era) and 2011 – 2018 (post-PCV13 era). CSF specimens were cultured for the isolation of S. pneumoniae and polymerase chain reaction was used for serotyping. Isolates were studied according to their serotype and antibiotic susceptibility profile, using the disc diffusion method on Mueller-Hinton Medium (MHM) according to Clinical and Laboratory guidelines.
Results
Overall, the prevalence of multidrug resistance increased in our study for commonly used antimicrobials (28% for cotrimoxazole and 22.2% for penicillin G from the pre- to post-PCV13 era), mainly driven by the continuous circulation of most PCV13 serotypes (e.g., 14[33.3%] and 6B [23.8%]). Chloramphenicol and tetracycline resistance were mainly associated with serotype 33F. Genomic sequencing data on 29 S. pneumoniae isolates showed that 28 of them harboured a resistant genotype to at least one antimicrobial, with PCV13-serotypes having more resistant genes than non-PCV13 serotypes.
Conclusions
PCV13-related BM was associated with increasing antimicrobial susceptibility in Cameroon. However, this is likely driven by the indiscriminate use of antibiotics in the country. Continuous surveillance and enhanced regulations are needed to ensure alignment in antibiotic stewardship goals.
