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Published on: February 15, 2013
Antimicrobial Susceptibility Pattern of Invasive Pneumococcal Isolates in North West Nigeria
Garba Lliyasu1, Abdulrazaq G Habib1, Aminu B Mohammad2
1Department of Medicine, College of Health Sciences, Bayero University Kano, Kano State, Nigeria.
Background:
An alarming increase in infections due to penicillin non-susceptible pneumococci (PNSP) has been documented in nearly all countries. Increasingly, PNSP are also resistant to other antibiotics, and a growing number of clinical failures following the use of these agents have been reported.
Aims:
To determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in North West Nigeria.
Materials And Methods:
In a cross-sectional study clinical specimens were obtained from patients with community acquired pneumonia (CAP), meningitis and bacteraemia over a 2 year period. Pneumococcus strains were identified. Isolates were tested against a panel of antibiotics using E-test strips, and interpreted according to the CLSI criteria. 0.06 μg/ml was used as break point for penicillin. Analysis was carried out using descriptive statistics; relationships determined using chi-squared or Fisher's exact tests, with P < 0.05 regarded as significant.
Results:
Total number of isolates was 132. Twenty-two (16.7%) of the isolates were fully sensitive to penicillin while 73 (55.3%) and 37 (28.0%) were intermediately and fully resistant, respectively. One hundred and twenty-seven (96.2%) of the isolates were fully resistant to trimethoprim-sulphamethoxazole. Eleven (8.5%) were fully resistant to amoxicillin and 104 (78.8%) and 17 (12.9%) were intermediately resistant and fully susceptible. One hundred and six (80.3%) of the isolates were fully susceptible to chloramphenicol. Resistance to penicillin was shown to infer resistance to other antibiotics.
Conclusions:
Pneumococcal resistance is common in North West Nigeria. Ceftriaxone retains excellent activity against most of the invasive isolate, while trimethoprim-sulphamethoxazole is almost uniformly resistant.
Insights
Pneumococcal resistance is a significant issue in North West Nigeria, with high rates of resistance to common antibiotics. Ceftriaxone remains effective, but trimethoprim-sulphamethoxazole shows near-universal resistance.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Penicillin non-susceptible pneumococci (PNSP) infections are increasing globally.
- PNSP exhibit resistance to multiple antibiotics, leading to treatment failures.
Purpose of the Study:
- To determine the antibiotic resistance patterns of pneumococcal isolates causing invasive infections in North West Nigeria.
Main Methods:
- A 2-year cross-sectional study analyzed clinical isolates from pneumonia, meningitis, and bacteremia.
- Antibiotic susceptibility testing was performed using E-test strips according to CLSI criteria.
Main Results:
- 132 pneumococcal isolates were analyzed; 28% were fully resistant to penicillin.
- High resistance rates were observed for trimethoprim-sulphamethoxazole (96.2%) and amoxicillin (8.5%).
- Penicillin resistance correlated with resistance to other antibiotics.
Conclusions:
- Pneumococcal resistance is prevalent in North West Nigeria.
- Ceftriaxone demonstrates good activity against invasive pneumococcal isolates.
- Trimethoprim-sulphamethoxazole is largely ineffective.
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