Puerperal Streptococcus pneumoniae endometritis : a case report and literature review

Streptococcus pneumoniae endometritis is an exceedingly rare clinical occurrence in the immunocompetent individual. This case report describes such an occurrence in an otherwise healthy woman 39 days post-normal vaginal delivery. The patient responded to prompt broad-spectrum intravenous antibiotics and made a full recovery. The clinical relevance of such a scenario, the likely pathogenesis of the event as well as a brief review of relevant clinical literature are discussed. Streptococcus pneumoniae genital infection was a well-documented clinical entity in the pre-antibiotic era with a high mortality rate – 26% for localised infection and 74% for peritonitis and sepsis. More recently, however, there have been only isolated reports of Streptococcus pneumoniae genital infection, with even less frequent accounts of this happening in immunocompetent individuals. In this report, we document a case of Streptococcus pneumoniae endometritis in a young, previously healthy female 39 days post-partum.peer-reviewe

Hubungan Kepadatan Hunian dan Paparan Asap Rokok terhadap Hasil Kultur Streptococcus pneumoniae pada Swab Nasofaring Anak Balita di Kota Padang

Pneumonia merupakan infeksi parenkim paru yang masih menjadi penyebab utama morbiditas dan mortalitas pada bayi dan anak di seluruh dunia. Salah satu bakteri penyebab pneumonia adalah Streptococcus pneumoniae. Kolonisasi Streptococcus pneumoniae pada nasofaring anak dapat dipengaruh oleh beberapa faktor risiko, termasuk faktor risiko kepadatan hunian dan paparan asap rokok. Tujuan: Mengetahui hubungan kepadatan hunian dan paparan asap rokok terhadap hasil kultur Streptococcus pneumoniae pada swab nasofaring anak balita di Kota Padang Penelitian ini merupakan analitik dengan desain cross sectional. Pengambilan sampel dilakukan dengan teknik consecutive sampling. Data yang dikumpulkan berupa data primer hasil kultur Streptococcus pneumoniae pada swab nasofaring dan data faktor risiko anak yang dirangkum pada lembar “Kuisioner Faktor Risiko Lingkungan pada Sampel terhadap Kolonisasi Streptococcus pneumoniae” Data dianalisis dengan uji chi-square dengan continuity correction. Hasil: didapatkan hasil positif kolonisasi Streptococcus pneumoniae pada 32 anak (57,1%) dengan persentase kelompok umur terbanyak adalah usia 2 bulan-1 tahun (66,7%). Analisis statistik menunjukkan hunian yang padat yang ditemukan kolonisasi Streptococcus pneumoniae adalah 17 anak (53,1%) dengan nilai p = 0,668 dan anak dengan paparan asap rokok yang ditemukan kolonisasi Streptococcus pneumoniae adalah 6 anak (25%) dengan nilai p = 0,831. Penelitian ini disimpulkan bahwa tidak adanya hubungan bermakna kepadatan hunian dan paparan asap rokok terhadap hasil kultur Streptococcus pneumoniae pada swab nasofaring anak balita di Kota Padang

Oropharyngeal Colonization by Streptococcus pneumoniae among Medical Students in Indonesia

Background: Streptococcus pneumoniae may colonize the upper respiratory tract without causing any symptoms. Medical students may be inhabited by these bacteria and transmit them to patients who were prone to infections. Streptococcus pneumoniae resistance to antibiotics was recently reported. This study was conducted to determine whether there was Streptococcus pneumoniae colonization among Medical Students of the Faculty of Medicine Universitas Padjadjaran Batch 2011 and analyze its susceptibility patterns towards several antibiotics.Methods: A descriptive study was conducted involving 75 Medical Students of the Faculty of Medicine Universitas Padjadjaran Batch 2011 that met the selection criteria. After informed consent, oropharyngeal throat swab was taken and further identification was carried out. Once Streptococcus pneumoniae colony was identified, susceptibility testing would be performed.Results: The identification results indicate that 7 students (9%) were colonized by Streptococcus pneumoniae. The susceptibility test showed that out of 7 isolates, 2 were resistant to 1 antibiotic, 1 was resistant to 2 antibiotics, and 4 were resistant to 3 antibiotics. Meanwhile, Streptococcus pneumoniae was resistant to trimethoprim-sulfamethoxazole (71%), oxacillin (71%), erythromycin (57%), and levofloxacin (14%).Conclusions: Streptococcus pneumoniae colonization is found among medical students. All Streptococcus pneumoniae are resistant to one or more antibiotics, mostly to trimethoprim-sulfamethoxazole and oxacillin. [AMJ.2016;3(3):349–54] DOI: 10.15850/amj.v3n3.878

Antibacterial Activity of Leaf Extracts of Anredera cordifolia (Ten.) Steenis and Muntingia calabura L. Against Streptococcus pneumoniae

Antibacterial resistance in Streptococcus pneumoniae has been increasing and is one of ongoing global concern.  The need to find new antibacterial agents against Streptococcus pneumoniae is of paramount importance. Medicinal plants are prospective sources of antibacterial agents. The aims of the present study were to determine the activity of leaf extraxt of Anredera cordifolia (Ten.) Steenis and Muntingia calabura L. against Streptococcus pneumoniae.  Leaves of Anredera cordifolia (Ten.) Steenis were extracted using 96% ethanol, while the leaves of Muntingia calabura L were extracted using 100% methanol.  The leaf extracts of the two plants obtained were bioassayed for antibacterial activity against Streptococcus pneumoniae ATCC 49619 and a clinical isolate Streptococcus pneumoniae PU 067.  Results showed that leaf extracts of both Anredera cordifolia (Ten.) Steenis and Muntingia calabura L. have antibacterial activity in vitro against Streptococcus pneumoniae ATCC 49619 at crude extract concentrations of 25%, 50%, 75% and 100% (w/v). Both plants extracts showed strongest activity against S. pneumoniae ATCC 49619 at extract concentration of 75%.   In addition, the extracts of both plants have inhibitory activity against growth of the clinical isolate Streptococcus pneumoniae PU 067. Both plant extracts showed strongest activity against S. pneumoniae PU 067 at extract concentration of 100%.  Therefore, leaf extracts of Anredera cordifolia (Ten.) Steenis and Muntingia calabura L. can potentially be used as a source of antibacterial agent for Streptococcus pneumoniae. Keywords: Antibacterial agent, Anredera cordifolia (Ten.) Steenis, Muntingia calabura L., Streptococcus pneumoniae

Pneumococcal carriage in sub-Saharan Africa--a systematic review.

BACKGROUND: Pneumococcal epidemiology varies geographically and few data are available from the African continent. We assess pneumococcal carriage from studies conducted in sub-Saharan Africa (sSA) before and after the pneumococcal conjugate vaccine (PCV) era. METHODS: A search for pneumococcal carriage studies published before 2012 was conducted to describe carriage in sSA. The review also describes pneumococcal serotypes and assesses the impact of vaccination on carriage in this region. RESULTS: Fifty-seven studies were included in this review with the majority (40.3%) from South Africa. There was considerable variability in the prevalence of carriage between studies (I-squared statistic = 99%). Carriage was higher in children and decreased with increasing age, 63.2% (95% CI: 55.6-70.8) in children less than 5 years, 42.6% (95% CI: 29.9-55.4) in children 5-15 years and 28.0% (95% CI: 19.0-37.0) in adults older than 15 years. There was no difference in the prevalence of carriage between males and females in 9/11 studies. Serotypes 19F, 6B, 6A, 14 and 23F were the five most common isolates. A meta-analysis of four randomized trials of PCV vaccination in children aged 9-24 months showed that carriage of vaccine type (VT) serotypes decreased with PCV vaccination; however, overall carriage remained the same because of a concomitant increase in non-vaccine type (NVT) serotypes. CONCLUSION: Pneumococcal carriage is generally high in the African continent, particularly in young children. The five most common serotypes in sSA are among the top seven serotypes that cause invasive pneumococcal disease in children globally. These serotypes are covered by the two PCVs recommended for routine childhood immunization by the WHO. The distribution of serotypes found in the nasopharynx is altered by PCV vaccination

Effects of deletion of the Streptococcus pneumoniae lipoprotein diacylglyceryl transferase gene lgt on ABC transporter function and on growth in vivo

Lipoproteins are an important class of surface associated proteins that have diverse roles and frequently are involved in the virulence of bacterial pathogens. As prolipoproteins are attached to the cell membrane by a single enzyme, prolipoprotein diacylglyceryl transferase (Lgt), deletion of the corresponding gene potentially allows the characterisation of the overall importance of lipoproteins for specific bacterial functions. We have used a Δlgt mutant strain of Streptococcus pneumoniae to investigate the effects of loss of lipoprotein attachment on cation acquisition, growth in media containing specific carbon sources, and virulence in different infection models. Immunoblots of triton X-114 extracts, flow cytometry and immuno-fluorescence microscopy confirmed the Δlgt mutant had markedly reduced lipoprotein expression on the cell surface. The Δlgt mutant had reduced growth in cation depleted medium, increased sensitivity to oxidative stress, reduced zinc uptake, and reduced intracellular levels of several cations. Doubling time of the Δlgt mutant was also increased slightly when grown in medium with glucose, raffinose and maltotriose as sole carbon sources. These multiple defects in cation and sugar ABC transporter function for the Δlgt mutant were associated with only slightly delayed growth in complete medium. However the Δlgt mutant had significantly reduced growth in blood or bronchoalveolar lavage fluid and a marked impairment in virulence in mouse models of nasopharyngeal colonisation, sepsis and pneumonia. These data suggest that for S. pneumoniae loss of surface localisation of lipoproteins has widespread effects on ABC transporter functions that collectively prevent the Δlgt mutant from establishing invasive infection

Genome analysis of a highly virulent serotype 1 strain of streptococcus pneumoniae from West Africa

Streptococcus pneumoniae is a leading cause of pneumonia, meningitis, and bacteremia, estimated to cause 2 million deaths annually. The majority of pneumococcal mortality occurs in developing countries, with serotype 1 a leading cause in these areas. To begin to better understand the larger impact that serotype 1 strains have in developing countries, we characterized virulence and genetic content of PNI0373, a serotype 1 strain from a diseased patient in The Gambia. PNI0373 and another African serotype 1 strain showed high virulence in a mouse intraperitoneal challenge model, with 20% survival at a dose of 1 cfu. The PNI0373 genome sequence was similar in structure to other pneumococci, with the exception of a 100 kb inversion. PNI0373 showed only15 lineage specific CDS when compared to the pan-genome of pneumococcus. However analysis of non-core orthologs of pneumococcal genomes, showed serotype 1 strains to be closely related. Three regions were found to be serotype 1 associated and likely products of horizontal gene transfer. A detailed inventory of known virulence factors showed that some functions associated with colonization were absent, consistent with the observation that carriage of this highly virulent serotype is unusual. The African serotype 1 strains thus appear to be closely related to each other and different from other pneumococci despite similar genetic content

Clonal expansion within pneumococcal serotype 6C after use of seven-valent vaccine

Streptococcus pneumoniae causes invasive infections, primarily at the extremes of life. A seven-valent conjugate vaccine (PCV7) is used to protect against invasive pneumococcal disease in children. Within three years of PCV7 introduction, we observed a fourfold increase in serotype 6C carriage, predominantly due to a single clone. We determined the whole-genome sequences of nineteen S. pneumoniae serotype 6C isolates, from both carriage (n = 15) and disease (n = 4) states, to investigate the emergence of serotype 6C in our population, focusing on a single multi-locus sequence type (MLST) clonal complex 395 (CC395). A phylogenetic network was constructed to identify different lineages, followed by analysis of variability in gene sets and sequences. Serotype 6C isolates from this single geographical site fell into four broad phylogenetically distinct lineages. Variation was seen in the 6C capsular locus and in sequences of genes encoding surface proteins. The largest clonal complex was characterised by the presence of lantibiotic synthesis locus. In our population, the 6C capsular locus has been introduced into multiple lineages by independent capsular switching events. However, rapid clonal expansion has occurred within a single MLST clonal complex. Worryingly, plasticity exists within current and potential vaccine-associated loci, a consideration for future vaccine use, target selection and design

The impact of pneumolysin on the macrophage response to Streptococcus pneumoniae is strain-dependent

Streptococcus pneumoniae is the world's leading cause of pneumonia, bacteremia, meningitis and otitis media. A major pneumococcal virulence factor is the cholesterol-dependent cytolysin, which has the defining property of forming pores in cholesterol-containing membranes. In recent times a clinically significant and internationally successful serotype 1 ST306 clone has been found to express a non-cytolytic variant of Ply (Ply306). However, while the pneumococcus is a naturally transformable organism, strains of the ST306 clonal group have to date been virtually impossible to transform, severely restricting efforts to understand the role of non-cytolytic Ply in the success of this clone. In this study isogenic Ply mutants were constructed in the D39 background and for the first time in the ST306 background (A0229467) to enable direct comparisons between Ply variants for their impact on the immune response in a macrophage-like cell line. Strains that expressed cytolytic Ply were found to induce a significant increase in IL-1β release from macrophage-like cells compared to the non-cytolytic and Ply-deficient strains in a background-independent manner, confirming the requirement for pore formation in the Ply-dependent activation of the NLRP3 inflammasome. However, cytolytic activity in the D39 background was found to induce increased expression of the genes encoding GM-CSF (CSF2), p19 subunit of IL-23 (IL23A) and IFNβ (IFNB1) compared to non-cytolytic and Ply-deficient D39 mutants, but had no effect in the A0229467 background. The impact of Ply on the immune response to the pneumococcus is highly dependent on the strain background, thus emphasising the importance of the interaction between specific virulence factors and other components of the genetic background of this organism

SMC is recruited to oriC by ParB and promotes chromosome segregation in Streptococcus pneumoniae

Segregation of replicated chromosomes is an essential process in all organisms. How bacteria, such as the oval-shaped human pathogen Streptococcus pneumoniae, efficiently segregate their chromosomes is poorly understood. Here we show that the pneumococcal homologue of the DNA-binding protein ParB recruits S. pneumoniae condensin (SMC) to centromere-like DNA sequences (parS) that are located near the origin of replication, in a similar fashion as was shown for the rod-shaped model bacterium Bacillus subtilis. In contrast to B. subtilis, smc is not essential in S. pneumoniae, and Δsmc cells do not show an increased sensitivity to gyrase inhibitors or high temperatures. However, deletion of smc and/or parB results in a mild chromosome segregation defect. Our results show that S. pneumoniae contains a functional chromosome segregation machine that promotes efficient chromosome segregation by recruitment of SMC via ParB. Intriguingly, the data indicate that other, as of yet unknown mechanisms, are at play to ensure proper chromosome segregation in this organism.