Concern over increased pneumonia cases as antibiotic resistance levels rise

A team from the Pneumococcal Reference Laboratory of the National Microbiology Center of the Carlos III Health Institute (ISCIII), which is part of the Ministry of Science, Innovation and Universities, has published a report research who analyzes the situation Invasive pneumococcal disease a Spain Between 2019 and 2023 in children and adults, highlighting the impact of the coronavirus pandemic.

Work published in the journal Infection MagazineThe use of non-pharmaceutical measures such as mask use, hand hygiene, quarantine and social distancing appears to have led to a “significant decline” in pneumococcal disease cases in the first two years of the pandemic.

But after these measures were lifted and eased, pneumococcal disease has rebounded and there is now a “Higher levels than before the pandemic».

The team responsible for the work is led by José Yust, a researcher at CNM-ISCIII, and also includes Julio Semper, Covadonga Pérez García, Samantha Hita, Aida Ubeda, Erick Joan Vidal, Joaquín Llorente and Mirian Domenech, from the World Pneumococcal Reference Laboratory. In addition, the CIBER-ISCIII Respiratory Diseases (CIBERES) and Epidemiology and Public Health (CIBERESP) departments, the Directorate-General for Public Health of the Ministry of Health, and several Spanish universities and hospitals collaborate.

Among the serotypes that have increased the most, as the work describes, are: Serotype 3which is one of those related high mortality ratewhich mainly affects the population under 5 years of age and adults over 65 years of age. It also highlights the presence of Serotype 4associated with infection in young people. On the other hand, Serotype 24F In the number of children and sPhenotype 8 It also continues to play an important role in the incidence of disease among the adult population.

If you are talking about Multi-resistant invasive strainsStreptococcus pneumoniae, or pneumococcus, has been shown to be the main cause of the disease. Pneumonia Bacterial pathogens, as well as sepsis and meningitis. This ISCIII study confirms the increase in cases due to invasive strains, some of which are associated with the disease. High levels of antibiotic resistancewhich is “a significant public health concern.”

In this sense, this same research team has already pointed to the year 2022, in a study published in Lancet microbeabout the possibility of an increase in cases due to resistant strains at the beginning of the epidemic. In addition to another previous study published in Clinical Infectious Diseases With data from 2009-2019, it was possible to create a “a map» Of invasive pneumococcal disease which also indicates an increase in cases.

The team led by Dr. Yusti concludes that the use of New vaccines Conjugates, with a greater range of protection and/or immunity than those previously available and recently authorized in Spain, could help prevent many of these conditions, including New emerging serotypes.

The ISCIII researcher points out that pneumococcal vaccination is not seasonal in the adult population and, therefore, Can be administered at any time of the year.Unlike flu vaccines, which change every year and must be given annually, the pneumococcal vaccine is generally given once in a lifetime.

The study also analyzed the impact that newly approved conjugate vaccines, as well as those in clinical development, could have in preventing new emerging serotypes that have emerged following the COVID-19 health crisis.

Increase since months

Experts have long warned of an increase in pneumococcal disease. Although it temporarily “disappeared” during the pandemic, mainly due to preventive measures taken to control the coronavirus, once it returned to normal, most viruses reappeared.

The ISCIII study also includes: Preventive and therapeutic measures Which could help combat and reduce the clinical impact of antibiotic resistance. “The antibiotics cefotaxime, which is given by injection (skin injection), and cefditoren, which is given orally, are the ones that showed the lowest levels of antibiotic resistance in pneumococci until the above-mentioned emerging serotypes were encountered,” explains Miriam Dominique, a researcher on the Yost team.

However, the key lies in the new conjugate vaccines, Yuste stresses.