Antimicrobial susceptibility of Streptococcus pneumoniae in adult patients with pneumococcal pneumonia in an urban hospital in Mozambique

BMC Research Notes

Jan M Prins³  Constance Schultsz⁴  Reindert P van Steenwijk²  Augusto C Macome¹  Esmeralda O Cossa¹  Elmano dos Santos Gomonda¹  Geoffrey C Madeira⁵  Sara J Beishuizen⁶  Jeannet C Bos⁴ 

[1]Hospital Central da Beira (HCB), Caixa Postal 1613, Beira, Mozambique

[2]Department of Pulmonology, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands

[3]Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Centre (AMC), University of Amsterdam, Room F4-217, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands

[4]Amsterdam Institute for Global Health and Development (AIGHD), Trinity Building C, Pietersbergweg 17, Amsterdam, 1105 BM, The Netherlands

[5]Faculdade de Ciências de Saúde, Universidade Católica de Moçambique (UCM), Caixa Postal 821, Beira, Mozambique

[6]University of Amsterdam (UvA), Faculty of Medicine, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

关键词: Sub-Saharan Africa;    Adults;    Pneumonia;    Antimicrobial susceptibility;    Penicillin resistance;    Streptococcus pneumoniae;   

Others  :  1134416
DOI  :  10.1186/1756-0500-7-110

 received in 2013-05-28, accepted in 2014-02-04,  发布年份 2014

【 摘 要 】

Background

Streptococcus pneumoniae is the leading cause of community–acquired pneumonia in Africa. Antimicrobial resistance of S. pneumoniae to penicillin and other commonly used antibiotics has increased worldwide. However, prevalence data from the African region are sparse, especially with regard to adults.

Findings

In this study, adult patients presenting at an urban referral hospital in central Mozambique were screened for pneumococcal pneumonia during an 8-week period in 2010: Patients with a respiratory syndrome underwent chest radiography and a sputum sample was collected for pneumococcal culture and antimicrobial susceptibility testing. A urine sample was tested for the presence of pneumococcal antigen.

177 patients with a respiratory syndrome were included. Overall, 41/177 (23%) patients fulfilled criteria for definite or probable pneumococcal pneumonia and in the group of patients with a positive chest x-ray this concerned 35/86 (41%) patients. 166 sputum cultures yielded 16 pneumococcal strains. One mg oxacillin disc testing identified potential penicillin resistance in 7/16 (44%) strains. Penicillin minimal inhibitory concentrations (MICs) were measured for 15 of these strains and ranged from <0.016-0.75 mg/L. No MICs >2 mg/L were found, but 3/15 (20%) pneumococcal strains had MICs >0.5 mg/L. All pneumococci were sensitive to erythromycin as measured by disc diffusion testing, whereas 44% was resistant to trimethoprim-sulfametoxazole.

Conclusions

The proportion of pneumonia cases attributable to pneumococcus appeared to be high. Whilst none of the S. pneumoniae strains tested were penicillin resistant, standard penicillin dosing for pneumonia may be insufficient given the observed range of pneumococcal penicillin MICs.

【 授权许可】

   
2014 Bos et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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