Changes in antimicrobial resistance of Streptococcus pyogenes in various clinical samples isolated over 10 years from all the regions of Pakistan

Abstract

Streptococcus pyogenes are highly prevalent bacterial pathogens worldwide, with humans representing their primary host. Respiratory tract diseases i.e., sinusitis, otitis media, pharyngitis, pneumonia and bronchitis are among the most common infections treated with antibiotics in patients of different age groups. Objective: This study aims to investigate changes in antibiotic susceptibility of S. pyogenes from the laboratory-oriented community and hospital-based data collected from HIS of Shaukat khanum hospital and research center from all the regions of Pakistan.Methods: For this purpose, retrospective data of all the group A Streptococci (GAS) reported patients was collected from the hospital over the period of past 10 years i.e., 2010-2020. Total 1409 number of clinical samples data was collected. The clinical samples collected were blood, pus, fluids, swabs and others (urine, aspirates, tip, abscesses, bone, tissue, necrotic material, effusions, washings and discharges). In the present study, six antibiotics were used ampicillin, ceftriaxone, penicillin, clindamycin, erythromycin and vancomycin in order to test the antibiotic susceptibility patterns by disc diffusion method (CLSI). Results: Data collected from all the provinces showed 100% sensitivity against all antibiotics except erythromycin and clindamycin. These two antibiotics erythromycin and clindamycin were least effective in Punjab, Sindh, Baluchistan, Azad Jammu & Kashmir and Fata. Conclusions: To conclude, S. pyogenes is responsive to four of the six antibiotics tested, while two are resistant. S. pyogenes was sensitive to ampicillin, ceftriaxone, penicillin, and vancomycin, but resistant to erythromycin and clindamycin. The findings serve as a starting point for further research into the genetic origins of S. pyogenes resistance on a molecular level.