Ashok K Tanwani, Shagufta Hussain, Shamim A Qazi, Mushtaq A Khan.
Prevalence of antimicrobial resistance of Streptococcus Pneumoniae and Hemophilus influenzae in children with pneumonia.
Ann Pak Inst Med Sci Jan ;1(2):105-9.

Background: Streptococcus pneumoniae and Hemophilus influenzae are the commonest causes of childhood bacterial pneumonia. High resistance 77% and 43% to cotrimoxazole for S. pneumoniae and H. influenzae, respectively were reported in Islamabad/Rawalpindi. Objective: To evaluate the prevalence of antimicrobial resistance in H. influenzae and S. pneumoniae. Place of Study: Pakistan Institute of Medical Sciences, Islamabad I Rawalpindi. Materials and Methods: Nasopharyngeal (NP) swabs from a total of 834 children clinically diagnosed with pneumonia and blood samples of 539 of these patients were collected. A total of 868 (635 NP and 133 blood) isolates (232 NP samples contained both organisms) were identified. These isolates were sent to Center for Disease Control and Prevention (CDCP), Atlanta, for minimum inhibitory concentration (MIC) levels of antimicrobials. Results: For cotrimoxazole MIC levels were > 1119 ug/ml in 73% (43.3% fully resistant MIC>4) and 70.6% for S. pneumoniae from NP and blood isolates respectively. The MIC levels > 1/19 of cotrimoxazole in NP and blood for H. influenzae isolates were 62.2% (19.8% fully resistant MIC > 4) and 54.9% (2.2% fully resistant). Erythromycin for H. influenzae showed MIC > 8 in 33.6% and 20.7% in NP and blood isolates. Penicillin had MIC levels > 0.12 in 26.2 (2.2% fully resistant MIC > 2) and 35.3% (3.2% fully resistant) for NP and blood isolates for S. pneumoniae. MIC levels > 8 for S. pneumoniae for chloramphenicol in NP and blood isolates was 18% and 15.7% respectively. The MIC levels showed high in-vitro antimicrobial resistance to cotrimoxazole as compared to other antibiotics tested in blood and NP isolates. Conclusion: Antimicrobial resistance of Streptococcus pneumoniae and Hemophilus influenzae in children with pneumonia is presented.

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