Prediction of Antibiotic Resistance in Streptococcus pneumoniae by Detection of Resistance Genes by Direct Quadruplex PCR in CSF from Patients with Acute Bacterial Meningitis

Abstract

Introduction: The bacterial etiology of meningitis in Burkina Faso is dominated by Neisseria meningitidis ( Nm ), Streptococcus pneumoniae ( Spn ) and Haemophilus influenzae ( Hi ), which are used epidemically. Low culture yields make it difficult to obtain data on the susceptibility profile of these pathogens. In the absence of such data, this study of resistance genes was initiated. Method: The aim of this study was to determine the wild-type gene pbp 2 b , the resistance genes mef and ermB , cat and tetM using Quadruplex real-time PCR directly on LCS samples, without prior extraction. Results: A total of 188 pneumococcal PCR-positive CSF samples were tested for resistance genes. The pbp 2 b gene was the most represented (166/188), followed by the tetM gene (158/188), the cat gene (37/188), the mef gene (25/188) and the ermB gene (10/188). Serotype 1 was dominant in 97/188 cases, with 22/97 carrying the cat gene , 9/97 the mef gene , 95/97 the pbp 2 b gene , 94/97 the tet gene and none the erm B gene . Conclusion: This study showed that around 88% of pneumococci carried the wild-type pbp 2 b gene , meaning that the majority were wild-type to penicillins. On the other hand, more than 80% of pneumococci carry the tetM gene , unlike ermB , mef and cat , whose carriage rates are 5, 13 and 19% respectively.