Antibiotic resistance makes pneumococcal disease more severe, increasing the risk of dangerous complications in Vietnamese children

Antibiotic resistance is making severe pneumococcal infections difficult to treat, increasing the risk of meningitis and sepsis, leaving long-term sequelae and even death.

On September 5, Associate Professor, Dr. Nguyen Thi Dieu Thuy, Head of the Department of Pediatrics, Hanoi Medical University, Head of the Department of Pediatrics, Hanoi Medical University Hospital, said that pneumococcus (Streptococcus pneumoniae) is one of the bacteria that reside in the respiratory tract. Many healthy people carry the bacteria without symptoms. However, when overcoming the body's protective barrier, pneumococcus can cause pneumonia, otitis media or, more dangerously, septicemia, meningitis and other dangerous complications, especially in young children.

Currently, many people still underestimate or even do not fully understand the burden of disease caused by pneumococcus, even though this is one of the leading dangerous invasive pathogens in young children. Previously, pneumococcus was relatively sensitive to common antibiotics. Children may only have ear infections or pneumonia and respond to empirical antibiotic treatment. However, in recent years, what is worrying is not only the number of sick children but also the more severe illness because pneumococcus is increasingly resistant to many antibiotics, making treatment more complicated," said Dr. Thuy.

According to research data at the National Children's Hospital recently published, 75% of pneumococcal strains causing invasive disease are resistant to third-generation cephalosporins, and nearly 100% are resistant to erythromycin and clindamycin. At City Children's Hospital, the resistance rate to some common antibiotic groups is also up to about 80%. Continuous exposure of bacteria to antibiotics creates selective pressure, making them resistant to survival and growth. Over time, they can become resistant to many drugs.

Experts say that the arbitrary use of antibiotics in the community is an important reason why bacteria are increasingly resistant, narrowing treatment options. When the first antibiotic is no longer effective, the doctor must change the regimen, choose a stronger antibiotic and closely monitor the response. With diseases like meningitis, every hour of delay in treatment can affect the long-term prognosis.

One characteristic that makes pneumococcus difficult to control is that this bacteria can exist in the nasopharynx of healthy people. Research published in 2026 estimates that about 33% of Vietnamese children carry pneumococcus in the nasopharynx without showing signs of illness. These people can become a source of infection for others, especially in families with many generations living together.

"Adults with good resistance can carry the bacteria without getting sick, but when they return home they can still transmit it to their children and grandchildren," Dr. Thuy explained.

In addition, pneumococcus has more than 100 different serotypes. Some pneumococcal types with notable prevalence in Vietnam include 6A, 19F, 6B, 23F, 14 and 19A. Of these, type 19F was recorded in 17% of children carrying pneumococcus and was involved in 25% of deaths due to invasive pneumococcal disease identified at the National Children's Hospital. Current vaccines do not cover everything but focus on types that are common and capable of causing severe disease. Vaccines help reduce the risk of severe illness and dangerous complications.

Antibiotic resistance is not just a problem of pneumococcus or Vietnam alone but has become a global health challenge. In a context where bacteria can quickly adapt to new drugs, the development of new antibiotics cannot compete with the speed of drug resistance formation. In the fight against drug-resistant pneumococcus, vaccines are considered one of the important disease prevention measures. Reducing the number of infections, especially severe infections, also means reducing the need for antibiotics and thereby contributing to limiting drug resistance pressure in the community.

Pneumococcal vaccines are increasingly expanding their coverage, from PCV7, PCV10, PCV13, PCV20 to new generation vaccines with a broader range of protection. However, vaccine selection, vaccination time and vaccination schedule should be based on the child's age, type of vaccine and recommendations from health authorities.