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Emergence of penicillin resistant pneumococci in Sri Lanka

N de Silva1, R Perera, L Mendis

  • 1Department of Microbiology, Faculty of Medicine, Colombo.

The Ceylon Medical Journal
|June 1, 1995
PubMed

Insights

Penicillin-resistant pneumococci, identified in Sri Lankan children with meningitis, show varying resistance levels. Despite sensitivity to other antibiotics, one case demonstrated therapeutic failure with penicillin.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Penicillin-resistant (PR) pneumococci pose a growing global health threat.
  • Pneumococcal meningitis remains a significant cause of morbidity and mortality, particularly in children.
  • Emergence of antibiotic resistance necessitates continuous surveillance and characterization of resistant strains.

Purpose of the Study:

  • To report the isolation and characterization of penicillin-resistant pneumococcal strains from pediatric meningitis cases in Sri Lanka.
  • To determine the antimicrobial susceptibility profiles of these resistant strains.
  • To highlight the clinical implications of penicillin resistance in pneumococcal meningitis.

Main Methods:

  • Isolation of pneumococcal strains from cerebrospinal fluid (CSF) of two pediatric meningitis patients.
  • Detection of penicillin resistance using the oxacillin disc diffusion method (Stokes method).
  • Quantitative determination of penicillin susceptibility via agar dilution technique to establish Minimum Inhibitory Concentrations (MICs).
  • Testing sensitivity to a panel of other antibiotics including erythromycin, tetracycline, chloramphenicol, amoxycillin, cephalexin, and cefotaxime.

Main Results:

  • Two strains of penicillin-resistant (PR) pneumococci were identified.
  • MIC values of 2 µg/ml and 0.12 µg/ml indicated frank and intermediate penicillin resistance, respectively.
  • Both strains remained sensitive to erythromycin, tetracycline, chloramphenicol, amoxycillin, cephalexin, and cefotaxime.
  • Therapeutic failure was observed in the case with intermediate penicillin resistance despite penicillin treatment.

Conclusions:

  • Penicillin-resistant pneumococci have emerged in Sri Lanka, as evidenced by these pediatric meningitis cases.
  • The presence of both frank and intermediate resistance highlights the evolving challenge of pneumococcal infections.
  • Clinical vigilance is crucial, as therapeutic failure can occur even with intermediate resistance, underscoring the need for appropriate antibiotic selection.

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