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

<h4>Background</h4>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 fo...

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Main Authors: Chittamas Panpaeng, Witchuda Kamolvit, Khemajira Karaketklang, Anupop Jitmuang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-05-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0013110
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author Chittamas Panpaeng
Witchuda Kamolvit
Khemajira Karaketklang
Anupop Jitmuang
author_facet Chittamas Panpaeng
Witchuda Kamolvit
Khemajira Karaketklang
Anupop Jitmuang
author_sort Chittamas Panpaeng
collection DOAJ
description <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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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spelling doaj-art-c0fff14cfcbe4354bfae064f7f2b277c2025-08-20T02:33:44ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-05-01195e001311010.1371/journal.pntd.0013110Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.Chittamas PanpaengWitchuda KamolvitKhemajira KaraketklangAnupop Jitmuang<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pntd.0013110
spellingShingle Chittamas Panpaeng
Witchuda Kamolvit
Khemajira Karaketklang
Anupop Jitmuang
Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
PLoS Neglected Tropical Diseases
title Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
title_full Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
title_fullStr Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
title_full_unstemmed Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
title_short Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007-2023.
title_sort clinical characteristics and trends in the antimicrobial susceptibility profile of streptococcus suis infections in a large tertiary hospital thailand 2007 2023
url https://doi.org/10.1371/journal.pntd.0013110
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