Abstract

Susceptibility of Streptococcus pneumoniae (pneumococci) to oxacillin and ceftriaxone was compared using disk diffusion and E-test methods. A total of 206 children attending Gertrude’s Children’s Hospital (GCH) were recruited. Sterile Copan Flocked Swabs were used to obtain nasopharyngeal swabs. Samples were inoculated on gentamicin blood agar and initial identification was done on the basis of colony morphology. Optochin test was performed to definitively identify the isolates as pneumococci. Antibiotic testing was done using disk diffusion and E-test methods on Muller Hinton agar enriched with 5% defibrinated sheep blood. A total of 42 (20%) isolates were recovered from the samples. Based on disk diffusion method, 74 and 40% of the isolates were resistant to oxacillin and ceftriaxone while; on the basis of E-test, 45 and 14% of the isolates were resistant to oxacillin and ceftriaxone, respectively. About 40% (n=17) of isolates that had zone diameters ≥ 20 mm which is considered susceptible to oxacillin by disk diffusion, had MICs ≤0.06 µg/ml correspondingly susceptible by E-test. Most isolates deemed susceptible to (≤0.5 µg/ml) ceftriaxone by E-test (72%, n=30) also exhibited susceptibility (≥27mm) to the antimicrobial agent by disk diffusion. E-test presents more sensitive results compared to disk diffusion. Isolates that exhibit resistance to penicillin and ceftriaxone by disk diffusion should be confirmed by E-test before being reported as resistant.   Key words: E-test, disk diffusion, antibiotic resistance, ceftriaxone and oxacillin.

Highlights

  • Pneumococcus (Streptococcus pneumoniae) kills over 1 million children across the world every year (Köksal et al, 2017)

  • A total of 42 pneumococci isolates were recovered from the samples and thereafter subjected to the study antibiotic agents using both E-test and disk diffusion methods

  • Based on disk diffusion findings, 74% (n=31) and 40% (n=17) of the isolates were resistant to oxacillin and ceftriaxone respectively

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Summary

Introduction

Pneumococcus (Streptococcus pneumoniae) kills over 1 million children across the world every year (Köksal et al, 2017). More than 50% of these fatalities occur in Africa (Pagan, 2011). To reverse this trend, the World Health Organization (WHO) recommends two major interventions: inclusion of higher valence conjugate vaccines in national immunization programs and judicious use of antibiotic agents (WHO, 2011). Kenya introduced the 10 valent pneumococcal conjugate vaccine (PCV-10) in her national immunization program (KEPI) in 2011 (Ojal et al, 2019). The uptake of the vaccine overtime surpassed the recommended threshold and cases of.

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