{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:12:42Z","timestamp":1789827162988,"version":"4.0.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013110","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000}}],"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec013\">\n<jats:title>Background<\/jats:title>\n<jats:p><jats:italic>Streptococcus suis<\/jats:italic> is an emerging pathogen causing invasive zoonotic infections in humans. Antimicrobial resistance (AMR) to penicillin, macrolides, and tetracyclines has emerged in <jats:italic>S. suis<\/jats:italic>-infected swine. AMR among zoonotic <jats:italic>S. suis<\/jats:italic> 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 <jats:italic>S. suis<\/jats:italic> infection in humans.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec014\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a chart review of adult patients with culture-confirmed <jats:italic>S. suis<\/jats:italic> infection in any body sites at Siriraj Hospital, Bangkok, Thailand, between May 2007 and May 2023. We also reviewed the AST profile of <jats:italic>S. suis<\/jats:italic> isolates during the study period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec015\">\n<jats:title>Results<\/jats:title>\n<jats:p>Over 16 years, 86 adult patients with <jats:italic>S. suis<\/jats:italic> infection were identified (59.3% male, mean age 59.29\u2009\u00b1\u200914.46 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 <jats:italic>S. suis<\/jats:italic> isolates tested, 48.2% were susceptible to penicillin (median MIC 0.064 [0.047\u20130.094] \u00b5g\/mL), 96.5% were susceptible to ceftriaxone (median MIC 0.380 [0.110\u20130.500] \u00b5g\/mL), and susceptibility to vancomycin, ofloxacin, tetracyclines, and clindamycin was 100%, 96.4%, 4.8%, and 1.2%, respectively. Penicillin MICs increased significantly (p\u2009&lt;\u20090.001), while other agents\u2019 profiles remained stable.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p><jats:italic>S. suis<\/jats:italic> can cause severe human infection, leading to fatal complications. <jats:italic>S. suis<\/jats:italic> displayed an upward trend of penicillin MICs and resistance to several antimicrobial agents. These findings underscore the need to monitor emerging resistance.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013110","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T17:55:54Z","timestamp":1747677354000},"page":"e0013110","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical characteristics and trends in the antimicrobial susceptibility profile of Streptococcus suis infections in a large tertiary hospital, Thailand, 2007\u20132023"],"prefix":"10.1371","volume":"19","author":[{"given":"Chittamas","family":"Panpaeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Witchuda","family":"Kamolvit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khemajira","family":"Karaketklang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4680-156X","authenticated-orcid":true,"given":"Anupop","family":"Jitmuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"issue":"6","key":"pntd.0013110.ref001","article-title":"Streptococcus suis, an important pig pathogen and emerging zoonotic agent-an update on the worldwide distribution based on serotyping and sequence typing","volume":"3","author":"G Goyette-Desjardins","year":"2014","journal-title":"Emerg Microbes Infect"},{"issue":"4","key":"pntd.0013110.ref002","doi-asserted-by":"crossref","first-page":"683","DOI":"10.26444\/aaem\/79813","article-title":"Streptococcus suis: a re-emerging pathogen associated with occupational exposure to pigs or pork products. Part I - Epidemiology","volume":"24","author":"J Dutkiewicz","year":"2017","journal-title":"Ann Agric Environ Med"},{"issue":"3","key":"pntd.0013110.ref003","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S1473-3099(07)70001-4","article-title":"Streptococcus suis: an emerging zoonotic pathogen","volume":"7","author":"Z-R Lun","year":"2007","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"pntd.0013110.ref004","first-page":"636","article-title":"Matched case-control study for risk factors of human Streptococcus suis infection in Sichuan Province, China","volume":"26","author":"H Yu","year":"2005","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"issue":"7","key":"pntd.0013110.ref005","first-page":"1105","article-title":"Epidemiology, clinical manifestations, and outcomes of Streptococcus suis infection in humans","volume":"20","author":"VTL Huong","year":"2014","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pntd.0013110.ref006","doi-asserted-by":"crossref","first-page":"13358","DOI":"10.1038\/s41598-018-31598-w","article-title":"Risk factors for Streptococcus suis infection: A systematic review and meta-analysis","volume":"8","author":"A Rayanakorn","year":"2018","journal-title":"Sci Rep"},{"key":"pntd.0013110.ref007","author":"Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health.","year":"2021"},{"key":"pntd.0013110.ref008","doi-asserted-by":"crossref","first-page":"3955","DOI":"10.2147\/IDR.S233326","article-title":"Clinical manifestations and risk factors of Streptococcus suis mortality among Northern Thai Population: retrospective 13-year cohort study","volume":"12","author":"A Rayanakorn","year":"2019","journal-title":"Infect Drug Resist"},{"issue":"4","key":"pntd.0013110.ref009","first-page":"868","article-title":"Streptococcus suis meningitis in Thailand","volume":"35","author":"C Suankratay","year":"2004","journal-title":"Southeast Asian J Trop Med Public Health"},{"issue":"10","key":"pntd.0013110.ref010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004191","article-title":"Streptococcus suis meningitis: a systematic review and meta-analysis","volume":"9","author":"A van Samkar","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pntd.0013110.ref011","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jinf.2005.02.012","article-title":"Streptococcus suis infection: a series of 41 cases from Chiang Mai University Hospital","volume":"52","author":"S Wangkaew","year":"2006","journal-title":"J Infect"},{"issue":"5","key":"pntd.0013110.ref012","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jinf.2008.08.006","article-title":"Streptococcus suis infection and risk factors for mortality","volume":"57","author":"W Wangsomboonsiri","year":"2008","journal-title":"J Infect"},{"issue":"9","key":"pntd.0013110.ref013","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.3390\/pathogens10091178","article-title":"Non-Penicillin-Susceptible Streptococcus suis Isolated from Humans","volume":"10","author":"N Bamphensin","year":"2021","journal-title":"Pathogens"},{"key":"pntd.0013110.ref014","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3389\/fmicb.2011.00235","article-title":"Streptococcus suis, an emerging drug-resistant animal and human pathogen","volume":"2","author":"C Palmieri","year":"2011","journal-title":"Front Microbiol"},{"issue":"1","key":"pntd.0013110.ref015","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12917-018-1732-5","article-title":"Antimicrobial susceptibility of Streptococcus suis isolated from diseased pigs, asymptomatic pigs, and human patients in Thailand","volume":"15","author":"S Yongkiettrakul","year":"2019","journal-title":"BMC Vet Res"},{"issue":"8","key":"pntd.0013110.ref016","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1017\/S0022215109004939","article-title":"Hearing and vestibular loss in Streptococcus suis infection from swine and traditional raw pork exposure in northern Thailand","volume":"123","author":"N Navacharoen","year":"2009","journal-title":"J Laryngol Otol"},{"issue":"5","key":"pntd.0013110.ref017","doi-asserted-by":"crossref","first-page":"835","DOI":"10.3201\/eid1705.100754","article-title":"Genotypic profile of Streptococcus suis serotype 2 and clinical features of infection in humans, Thailand","volume":"17","author":"A Kerdsin","year":"2011","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"pntd.0013110.ref018","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1086\/527385","article-title":"Streptococcus suis meningitis in adults in Vietnam","volume":"46","author":"NTH Mai","year":"2008","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pntd.0013110.ref019","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1086\/596763","article-title":"Streptococcus suis: an emerging human pathogen","volume":"48","author":"HFL Wertheim","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"2","key":"pntd.0013110.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0031265","article-title":"Population-based study of Streptococcus suis infection in humans in Phayao Province in northern Thailand","volume":"7","author":"D Takeuchi","year":"2012","journal-title":"PLoS One"},{"issue":"11","key":"pntd.0013110.ref021","doi-asserted-by":"crossref","first-page":"359","DOI":"10.3390\/tropicalmed7110359","article-title":"Human Streptococcus suis infections in thailand: epidemiology, clinical features, genotypes, and susceptibility","volume":"7","author":"A Kerdsin","year":"2022","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"pntd.0013110.ref022","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1186\/s12879-024-10180-y","article-title":"Streptococcus suis infective endocarditis in patients with Streptococcus suis bacteremia: a retrospective study of prevalence and outcomes","volume":"24","author":"P Kedsawadevong","year":"2024","journal-title":"BMC Infect Dis"},{"key":"pntd.0013110.ref023","article-title":"Streptococcus suis endocarditisechocardiographic features and clinical outcomes","volume":"8","author":"K Trirattanapa","year":"2021","journal-title":"Open Forum\u00a0Infect. Dis"},{"issue":"3","key":"pntd.0013110.ref024","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4269\/ajtmh.22-0515","article-title":"Clinical characteristics and follow-up of cases of Streptococcus suis meningitis in patients of Liuzhou, China","volume":"108","author":"S Deng","year":"2023","journal-title":"Am J Trop Med Hyg"},{"issue":"12","key":"pntd.0013110.ref025","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1017\/S0950268808000332","article-title":"Streptococcus suis infection in Hong Kong: an emerging infectious disease?","volume":"136","author":"E Ma","year":"2008","journal-title":"Epidemiol Infect"},{"issue":"24","key":"pntd.0013110.ref026","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1056\/NEJMoa070852","article-title":"Dexamethasone in Vietnamese adolescents and adults with bacterial meningitis","volume":"357","author":"THM Nguyen","year":"2007","journal-title":"N Engl J Med"},{"issue":"3","key":"pntd.0013110.ref027","doi-asserted-by":"crossref","first-page":"295","DOI":"10.7883\/yoken.JJID.2016.294","article-title":"A Decennium of Etiology and Antimicrobial Susceptibility Patterns in Patients with Infective Endocarditis at a University Hospital, Thailand","volume":"70","author":"C Nakaranurack","year":"2017","journal-title":"Jpn J Infect Dis"},{"issue":"3","key":"pntd.0013110.ref028","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3390\/antibiotics11030410","article-title":"Antimicrobial susceptibility of Streptococcus suis isolated from diseased pigs in Thailand, 2018-2020","volume":"11","author":"K Lunha","year":"2022","journal-title":"Antibiotics (Basel)"},{"issue":"2","key":"pntd.0013110.ref029","article-title":"Streptococcus suis outbreak caused by an emerging zoonotic strain with acquired multi-drug resistance in Thailand","volume":"9","author":"J Brizuela","year":"2023","journal-title":"Microb Genom"},{"issue":"2","key":"pntd.0013110.ref030","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-001918","article-title":"How antibiotics are used in pig farming: a mixed-methods study of pig farmers, feed mills and veterinarians in Thailand","volume":"5","author":"A Lekagul","year":"2020","journal-title":"BMJ Glob Health"},{"key":"pntd.0013110.ref031","doi-asserted-by":"crossref","first-page":"659051","DOI":"10.3389\/fvets.2021.659051","article-title":"Geographic drivers of antimicrobial use and resistance in pigs in khon kaen province, Thailand","volume":"8","author":"L Huber","year":"2021","journal-title":"Front Vet Sci"},{"key":"pntd.0013110.ref032","volume-title":"Performance Standards for Antimicrobial Disk Susceptibility TestsCLSI standard M02","author":"CLSI","year":"2018"},{"key":"pntd.0013110.ref033","volume-title":"Performance Standards for Antimicrobial Susceptibility TestingCLSI M100","author":"CLSI","year":"2019"},{"issue":"15","key":"pntd.0013110.ref034","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1161\/CIR.0000000000000296","article-title":"Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association","volume":"132","author":"LM Baddour","year":"2015","journal-title":"Circulation"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013110","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T20:05:48Z","timestamp":1748635548000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013110"}},"subtitle":[],"editor":[{"given":"Joseph M.","family":"Vinetz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013110","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]}}}