Panpaeng Chittamas, Kamolvit Witchuda, Karaketklang Khemajira, Jitmuang Anupop
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
PLoS Negl Trop Dis. 2025 May 19;19(5):e0013110. doi: 10.1371/journal.pntd.0013110. eCollection 2025 May.
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.
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.
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.
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.
猪链球菌是一种新兴病原体，可引起人类侵袭性人畜共患病感染。在感染猪链球菌的猪中已出现对青霉素、大环内酯类和四环素类的抗菌药物耐药性（AMR）。人畜共患猪链球菌菌株中的AMR引起了对人类感染和抗菌治疗选择的严重关注。因此，本研究旨在描述猪链球菌感染人类的临床特征，并探索其抗菌药物敏感性（AST）的变化模式。
我们对2007年5月至2023年5月期间泰国曼谷诗里拉吉医院成年患者中经培养确诊的任何身体部位猪链球菌感染病例进行了病历回顾。我们还回顾了研究期间猪链球菌分离株的AST情况。
在16年期间，共识别出86例成年猪链球菌感染患者（男性占59.3%，平均年龄59.29±14.46岁）。其中，60.5%患有合并症（高血压43%、血脂异常23.3%、糖尿病20.9%、酗酒19.8%），35.0%在发病前中位数为1（0.0 - 6.5）天有猪接触史。临床表现包括败血症（91.9%）、脑膜炎（30.2%）、心内膜炎（26.7%）和化脓性关节炎（9.3%），导致多器官功能障碍（32.5%）、心肺衰竭（26.8%）、肾衰竭（17.4%）和感染性休克（14.0%）。死亡率为7%。确定性治疗主要使用头孢曲松（76.7%）或青霉素（8.1%）作为基础方案。在检测的猪链球菌分离株中，48.2%对青霉素敏感（MIC中位数为0.064[0.047 - 0.094]μg/mL），96.5%对头孢曲松敏感（MIC中位数为0.380[0.110 - 0.500]μg/mL），对万古霉素、氧氟沙星、四环素和克林霉素的敏感性分别为100%、96.4%、4.8%和1.2%。青霉素的MIC显著增加（p<0.001），而其他药物的情况保持稳定。
猪链球菌可导致严重的人类感染，引发致命并发症。猪链球菌对青霉素的MIC呈上升趋势，且对多种抗菌药物耐药。这些发现强调了监测新出现耐药性的必要性。
