What does this research mean for the field?

Human Streptococcus suis infections frequently present with severe complications such as septicemia and meningitis, and the pathogen exhibits an upward trend in penicillin minimum inhibitory concentrations (MICs) alongside high resistance to tetracyclines and clindamycin. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To examine the clinical characteristics and trends in antimicrobial susceptibility of Streptococcus suis infections in humans over a 16-year period.

May 19, 2025PLoS neglected tropical diseases11 citationsOpen Access

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Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007–2023

CPChittamas Panpaeng WKWitchuda Kamolvit KKKhemajira Karaketklang

Key Points

To examine the clinical characteristics and trends in antimicrobial susceptibility of Streptococcus suis infections in humans over a 16-year period.
Chart review of adult patients with culture-confirmed S. suis infection from May 2007 to May 2023 at Siriraj Hospital, Thailand.
Review of antimicrobial susceptibility testing (AST) profiles of S. suis isolates during the study period.
Among 86 identified patients, 91.9% presented with septicemia and mortality was 7%.
48.2% of isolates were susceptible to penicillin, with significant increases in penicillin MICs (p < 0.001).
Ceftriaxone showed 96.5% susceptibility, while other antimicrobials like vancomycin and ofloxacin remained stable.

Abstract

BACKGROUND: Streptococcus suis is an emerging pathogen causing invasive zoonotic infections in humans. Antimicrobial resistance (AMR) to penicillin, macrolides, and tetracyclines has emerged in S. suis-infected swine. AMR among zoonotic S. suis strains causes a critical concern for human infection and antimicrobial treatment options. Thus, the study aims to delineate the clinical characteristics and to explore the changing pattern of the antimicrobial susceptibility (AST) of S. suis infection in humans. METHODS: We conducted a chart review of adult patients with culture-confirmed S. suis infection in any body sites at Siriraj Hospital, Bangkok, Thailand, between May 2007 and May 2023. We also reviewed the AST profile of S. suis isolates during the study period. RESULTS: Over 16 years, 86 adult patients with S. suis infection were identified (59.3% male, mean age 59.29 ± 14.46 years). Of them, 60.5% had comorbidities (hypertension 43%, dyslipidemia 23.3%, diabetes mellitus 20.9%, alcoholism 19.8%), and 35.0% had swine contact a median of 1 (0.0-6.5) days before onset. Clinical presentations included septicemia (91.9%), meningitis (30.2%), endocarditis (26.7%), and septic arthritis (9.3%), leading to multiorgan dysfunction (32.5%), cardiopulmonary failure (26.8%), renal failure (17.4%), and septic shock (14.0%). Mortality was 7%. Definitive therapy primarily used ceftriaxone (76.7%) or penicillin (8.1%) as a basis regimen. Among S. suis isolates tested, 48.2% were susceptible to penicillin (median MIC 0.064 0.047-0.094 µg/mL), 96.5% were susceptible to ceftriaxone (median MIC 0.380 0.110-0.500 µg/mL), and susceptibility to vancomycin, ofloxacin, tetracyclines, and clindamycin was 100%, 96.4%, 4.8%, and 1.2%, respectively. Penicillin MICs increased significantly (p < 0.001), while other agents' profiles remained stable. CONCLUSIONS: S. suis can cause severe human infection, leading to fatal complications. S. suis displayed an upward trend of penicillin MICs and resistance to several antimicrobial agents. These findings underscore the need to monitor emerging resistance.

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Cite This Study

Panpaeng et al. (Mon,) studied this question.

synapsesocial.com/papers/6a1af3279fa30811a0b9544a https://doi.org/https://doi.org/10.1371/journal.pntd.0013110

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