Resistance Patterns of Streptococcus pneumoniae and Haemophilus influenzae Isolates Recovered in Egypt from Children with Pneumonia

Abstract

Treatment of childhood pneumonia in developing countries requires knowledge of susceptibility patterns for Streptococcus pneumoniae and Haemophilus influenzae. Between October 1991 and April 1993, a surveillance survey of antimicrobial resistance was performed at two fever hospitals in Egypt; nasopharyngeal swab and blood specimens obtained from 1,635 children with pneumonia were cultured for these organisms. Susceptibility testing of these organisms was performed. At least one of these organisms was isolated from nasopharyngeal swab specimens from 73% of the children; 3.7% of blood cultures were positive. For S. pneumoniae strains, 70.9% of nasopharyngeal isolates were calculated to be susceptible to penicillin vs. 77.6% of blood isolates; the percentages of isolates susceptible to co-trimoxazole were 73.0% and 75.0%, respectively. For H. influenzae strains, 93.0% of nasopharyngeal isolates were calculated to be susceptible to ampicillin vs. 100% of blood isolates; the percentages of isolates susceptible to co-trimoxazole were 84.9% and 100%, respectively. Although most S. pneumoniae and H. influenzae strains associated with childhood pneumonia in Cairo were susceptible to penicillins and co-trimoxazole, antimicrobial resistance did not occur.

Trends in antibiotic resistance of respiratory tract pathogens in children in Geneva, Switzerland

“…No multidrug resistant H. influenzae strain has yet been identified in Geneva. Invasive strains have been found to be more resistant to ampicillin than non-invasive strains (27% vs. 12%, P<0.05), contrasting other reports [23].…”

National surveillance programme on susceptibility patterns of respiratory pathogens in South Africa: moxifloxacin compared with eight other antimicrobial agents

“…For example, in Egypt 25% of strains were resistant during the period 1991 to 1993. 16 Of great concern is the rapid increase in macrolide resistance seen over the past few years in South African isolates of pneumococci. Only 6-7% of the strains tested in the Alexander study, which were collected during 1996 to 1997, were macrolide resistant.…”

Chloramphenicol versus ampicillin plus gentamicin for community acquired very severe pneumonia among children aged 2-59 months in low resource settings: multicentre randomised controlled trial (SPEAR study)

“…7 8 Although chloramphenicol may have had some advantages in the past, the increasing resistance of bacteria, particularly H influenzae and S aureus, to this antibiotic adds to the longstanding concerns that it is bacteriostatic and associated with bone marrow toxicity, particularly in malnourished children. [9][10][11][12][13][14] An alternative regimen already being used in some areas, combined ampicillin and gentamicin, is bactericidal and provides good coverage against H influenzae, S pneumoniae, E coli, and Proteus mirabilis. The combination is synergistic and bactericidal against the common Gram negative organisms associated with very severe pneumonia, including E coli, Enterobacter spp, Klebsiella spp, Proteus spp, Serratia spp, and Citrobacter spp.…”