A Study Of Streptococcus Pneumoniaeresistance Patterns At Kenyatta National Hospital Between January 2011 And December 2012.

Abstract

Background: Streptococcus pneumoniae infections are a concern to the stake holders in the healthcare sector not only because of their expanding spectrum of resistance but also because of their propensity to affect the most vulnerable members of the population; the paediatrics and the geriatrics. What makes the matter even worse is that the microorganism mode of resistance evolves rapidly such that it even becomes resistant to the newest drugs in the market. Study Objective: To study the patterns of Streptococcus pneumoniae resistance, then make comparisons between the year 2011 and 2012. Study Design: A retrospective study based on secondary data collected from patient records,both hospital files and electronic data bases (dispensing tools). Subjects: Streptococcus pneumonia infected persons, both paediatrics and geriatrics from January, 2011 to December 2012. Study Site: Kenyatta National Hospital (KNH) Main Outcome Measures: Documented drug resistance levels over a 2 year period. Results: All S. pneumonia patients' records were reviewed. Of the 19 cases identified, 10 (52.6%) were found to be resistant. Generally cases of resistance were higher in 2011 (31.6%) than in 2012 (21.1%). Age group :s2-15yrs accounted for most of the resistant cases in 2011(57.1%) followed by group 16-50 years (42.9%), while age group 16-50 years accounted for most of the resistant cases in 2012 (66.7%). Age group of people >60years had the least number of resistant cases (zero in 2011 and 16.7% in 2012). In 2011 S. pneumonia was most resistant to co-trimoxazole (57.1%), followed by tetracycline 28.6%, and levofloxacin at 14.3%. In 2012, the organism was most resistant to co-trimoxazole (50%), followed by tetracycline (33.3%) and Co-amoxyclav (16.7%). Conclusion: Levels of resistance to S. pneumoniae were lower in 2011, than 2012 but were still high within the age group <2-15years and amongst cotrimoxazole and tetracycline. Pneumonia was prevalent amongst children and other age groups. Therefore concerted efforts should be directed towards ensuring complete eradication of its causative organisms.