Importance of bacterial resistance in streptococcus pneumoniae and streptococcus pyogenes in the center region in Cameroon

Respiratory tract infections are a real public health problem; and the few studies of African data make difficult the definition of a probabilistic rational therapeutic approach. The present study from May 2006 to June 2007 included 107 strains of Streptococcus pneumoniae and 94 strains of Streptococcus pyogenes. A single isolate was collected by topic; and the minimum inhibitory concentration (MIC) has been made by the E test method; 201 strains from 115 adults and 86 children were included in the study. From 107 strains of S. pneumoniae; 24 were from children; and from 94 strains of S. pyogenes; 62 came from child. From antibiotics susceptibility of S. pyogenes; 100% were sensitive to penicillin G; with MIC between 0.064 and 0.128; 20 were resistant to erythromycin; and 100% were sensitive to levofloxacin; chloramphenicol; amoxicillin; cefotaxime; and ceftriaxone. From S. pneumoniae; 95.3% were sensitive to penicillin G and 4.7% were intermediate; 19.3% were resistant to erythromycin; 100% were sensitive to levofloxacin; cefotaxime amoxicillin; and ceftriaxone

Etude de la sensibilite aux antibiotiques et des genes de resistance aux macrolides de streptococcus pneumoniae isole en milieu pediatrique tunisien

L'emergence de souches resistantes pose des problemes therapeutiques.Le but de cette etude etait de preciser : les caracteristiques epidemiologiques des souches de S. pneumoniae isolees chez l'enfant; leur sensibilite aux antibiotiques et les genes de resistance aux macrolides. L'etude a porte sur 422 souches non repetitives de S. pneumoniae isolees de 2000 a 2008. Les souches invasives (43;3) provenaient essentiellement de LCR (50;2) et d'hemocultures (34;4); la majorite des souches non invasives (56;6) de prelevements pulmonaires (76;5). Le pneumocoque de sensibilite diminuee a la penicilline G (PSDP) representait 53;3des souches (n=225) et 12;8avaient une resistance de haut niveau.29;6avaient une sensibilite diminuee a l'amoxicilline et 15;1au cefotaxime. 60;6des souches etaient resistantes a l'erythromycine et 59;6a la lincomycine. L'etude parPCR des genes de resistance a montre que parmi les 66 souches testees; 62 hebergeaient le gene ermB; 3 le gene mefA et une souche les 2 genes. Les PSDP etaient beaucoup plus resistants aux differents antibiotiques testes que les pneumocoques sensibles a la penicilline; ceci complique la prise en charge therapeutique de ces infections et justifie leur prevention par l'utilisation d'un vaccin anti-pneumococcique efficace

Carriage Rates; Circulating Serotypes and Antibiotic Resistance among Streptococcus Pneumoniae in Healthy Infants in Yei; South Sudan

The carriage of Streptococcus pneumoniae; serotypes; antimicrobial susceptibility patterns and disease development are poorly understood in Yei. Availability of affordable antibiotics over the counter; lack of laboratory infrastructure and high rates of penicillin resistance have the potential to aggravate rates of childhood mortality associated with Streptococcus pneumoniae. There is an urgent need to strengthen microbiological and public health services

Antibacterial evaluation of selected Moroccan medicinal plants against Streptococcus pneumoniae

In Morocco, most people particularly in rural areas use medicinal plants to treat diseases. In order to find new antipneumococcal extracts, an ethnobotanical survey has been conducted in different regions of Marrakesh (south of Morocco). Four plants often cited by traditional practitioners (Marrubium vulgare, Thymus pallidus, Eryngium ilicifolium and Lavandula stoechas) are tested against Streptococcus pneumoniae responsible for pharyngitis, rhinitis, otitis and sinusitis infections. Aqueous and methanol extracts have been prepared and tested on S. pneumoniae collected in four regions of Marrakesh. A significant activity has been observed with methanol extracts of three plants; M. vulgare, T. pallidus and L. stoechas (MIC= 256 µg/ml)

Antimicrobial Resistant Profile of Streptococcus Pneumoniae Isolated from the Nasopharynx of Secondary School Students in Jos; Nigeria

Background: Antimicrobial resistance in Streptococcus pneumoniae has compromised the effectiveness of therapy for pneumococcal diseases and asymptomatic nasopharyngeal carriers play an important role in transmission of resistant strains. Method: Eighty-eight volunteer students attending 2 secondary schools in Jos; Nigeria were involved in this study to determine the antimicrobial resistant profile of Streptococcus pneumoniae isolated from the nasopharynx. The study population consisted of males and females between the ages of 15 - 25 years. Nasopharyngeal swab samples were analyzed for the presence of S. pneumoniae using standard bacteriological methods. The Results: S. pneumoniae was isolated from 37(42.04) of the 88 samples. Isolates showed the highest resistance of 12 (32.43) to erythromycin and lowest resistance of 4(10.81) to ciprofloxacin. The resistance profiles for the 26(70.27) penicillin-sensitive and 11(29.72) penicillin-resistant isolates were similar. Both exhibited varying degrees of resistance to several groups of antimicrobials. However; isolates found to be resistant to penicillin showed a higher degree of resistance to other antimicrobial agents. Conclusion: This study has shown that some secondary school students are carriers of multiple antibiotic-resistant S. pneumoniae

Streptococcus pneumoniae carriage rates among infants in Owerri, Nigeria

A microbiological survey was carried out on children attending the Paediatric Clinic of the Federal Medical Centre in Owerri; Edo State; Nigeria. The study was carried out to determine the carriage rate of Streptococcus pneumoniae; the common cause of acute cold and death among children. Of a total of 71 specimens; S pneumoniae was isolated from 49; a prevalence of 69. Sex distribution showed that females had a higher carriage rate than males (55vs 45; p=0.05). Children between 12 months and 4 years of age had higher prevalence rates of S pneumoniae than children under 12 months and over 4 years

Pneumococcal disease in sub-Saharan African children: what is the effectiveness of the pneumococcal conjugate vaccine?

Streptococcus pneumoniae is still a leading cause of morbidity and mortality among children in developing countries. Young children represent a high-risk group for severe pneumococcal disease; not only because of their physio-logical susceptibility but also because polysaccharide vaccines are not effective for them. Pneumococcal conjugate vaccines have shown a high protection against pneumococcal diseases all over the world. Therefore; the expanded use of this vaccine must be considered as a major world health priority

Introduction of the Pneumococcal Conjugate Vaccine into the South African Public Immunisation Programme: Dawn of a New Era?

Streptococcus pneumoniae is a leading vaccine-preventable cause of childhood death with an estimated 716;000 deaths occurring annually. Recent advances have seen the development of vaccines targeted against S. pneumoniae that are immunogenic and efficacious in very young children. These pneumococcal conjugate vaccines have now been evaluated in developed and industrialising countries with consistent efficacy against invasive pneumococcal disease at least due to the serotypes included in the vaccine. The vaccine has also been efficacious in preventing radiographically confirmed pneumonia; but has had less effect on pneumococcal acute otitis media. The introduction of the vaccine into the USA has been greatly successful and exceeds its expectations based upon the vaccine efficacy trials. In addition to preventing a greater than expected burden of invasive disease and pneumonia than anticipated in vaccinated children; the vaccine has also been associated with marked reduction in pneumococcal disease among unvaccinated members of the population; referred to as `indirect protection'. The introduction of the vaccine into the immunisation programme of industrialising countries; such as in South Africa; require robust surveillance to evaluate the effectiveness of the vaccine in such settings where the epidemiology of pneumococcal diseases differs to that in developed countries

Les meningites purulentes a Streptococcus pneumoniae de l'adulte a Dakar

Pour decrire les aspects epidemiologiques; cliniques; evolutifs et bacteriologiques des meningites a pneumocoque de l'adulte a Dakar; nous avons realise une etude retrospective portant sur les dossiers des meningites a pneumocoques hospitalisees de 1995 a 2004; a la Clinique des Maladies Infectieuses du CHNU de Fann-Dakar. Au total; 73 cas de meningites a pneumocoque ont ete colliges durant cette periode; ou ce germe a ete la deuxieme cause de meningite purulente apres le meningocoque. L'infection a VIH (9 cas) et la drepanocytose (3 cas) etaient les facteurs sous-jacents les plus retrouves et les pneumopathies; les principales portes d'entree (51;8). Les formes comateuses etaient plus frequentes (61;6). Les pneumocoques a sensibilite diminuee a la penicilline (PSDP) representaient 27;3des souches qui par ailleurs etaient sensibles aux cephalosporines de 3e generation (100); et au chloramphenicol (68;2); antibiotiques les plus utilises. Le taux de letalite etait de 69;8et les complications neurosensorielles etaient notees chez 13;7des cas. Les principaux facteurs de mauvais pronostic etaient : un collapsus cardiovasculaire et /ou un coma a l'admission et la mise en evidence du pneumocoque a l'examen direct du LCR. La forte letalite des meningites purulentes a pneumocoque de l'adulte a Dakar impose une amelioration du plateau de reanimation et l'augmentation des PSDP necessite une meilleure reglementation de la prescription des antibiotiques

Evaluation of 17 Medicinal Plants from Northern Cote d'Ivoire for their in Vitro Activity against Streptococcus Pneumoniae

A total of 20 Cote d'Ivoire plant extracts; belonging to 17 different species out of 11 families; were investigated for their antibacterial activity against Streptococcus pneumoniae (Pneumococcus). The plants were selected on the base of their ethnomedicinal use; in Northern Cote d'Ivoire; against various infections such as upper track diseases. From all the crude extracts tested; only 7 from 6 plant species showed a promising in vitro bactericidal activity against peumococcus; some of which were resistant to penicillin. The most active extracts were from Erythrina senegalensis (Fabaceae); Piliostigma thonningii (Caesalpiniaceae); Waltheria indica (Sterculiaceae); Andira inermis (Fabaceae); Uapaca togoensis (Euphorbiaceae); Keetia hispida (Rubiaceae) and Combretum molle (Combretaceae). This is the first report of the antipneumococcal activity of the tested plant species. The results of this preliminary investigation support the traditional use of the active plants in the treatment of pneumococcal infections. The most active could be candidates for isolation of compounds which could develop into new lead structures for drugs against Streptococcus pneumoniae

Evaluation of 17 Medical Plants from Northern Cote d'Ivoire for their in vitro Activity Againts Streptococcus Pneumoniae

Twenty crude extracts from 17 species out of 11 families were assessed for their antibacterial activity against Streptococcus pneumoniae (Pneumococcus). The selected plants are used in Northern Cote d'Ivoire to treat various infections including respiratory track diseases. From all the tested extracts; only 7 from 6 plants showed a promising in vitro bactericidal activity against Peumococcus; including strains resistant to penicillin. The most active extracts were from Erythrina senegalensis (Fabaceae); Piliostigma thonningii (Caesalpiniaceae); Waltheria indica (Sterculiaceae); Andira inermis (Fabaceae); Uapaca togoensis (Euphorbiaceae); Keetia hispida (Rubiaceae) and Combretum molle (Combretaceae). This is the first time that the antipneumococcal activity of the tested plants is reported. The results of this preliminary investigation support the traditional use of these plants in the treatment of pneumococcal infections. The most active of them could be candidates for isolation of compounds which could serve as lead structures for the development of new drugs against Streptococcus pneumoniae

Empyema and parapneumonic effusions in children: an update

Childhood empyema is an important complication of bacterial pneumonia. The incidence of empyema is increasing worldwide. Streptococcus pneumoniae and Staphylococcus aureus are the most common aetiologies in high and low-income countries respectively. The diagnosis is based on clinical; radiographic and pleural fluid examination. Tuberculosis (TB) is an important cause of a pleural effusion in high TB prevalence areas. There is controversy about the optimal treatment for empyema in children. Sepsis should be controlled with antibiotics and drainage of the pleural cavity. Intrapleural fibrinolysis and Video Assisted Thorascopic Surgery (VATS) are modern interventions widely used in high-income countries but mostly unavailable in the developed world. There are however few properly conducted studies that would support one therapeutic approach over the other. Despite this; the clinical outcome of paediatric empyema is usually good regardless of therapeutic approach. This review summarises aetiology; pathogenesis and clinical presentation of childhood empyema and discusses the various treatment modalities with an emphasis on clinical practice in developing countries

Peritonites primitives en Afrique subsaharienne : a propos de 15 cas

La peritonite primitive (PP) est une infection du peritoine sans etiologie septique intraperitoneale. Souvent decrite chez le cirrhotique; elle est rare chez le sujet sain. Nous rapportons une etude retrospective sur 3 ans de 15 cas pris en charge a l'Hopital Principal de Dakar. Tous les patients ont ete operes. Les prelevements bacteriologiques per-operatoires ont ete systematiques. La population etait jeune (2 patients avaient plus de 13 ans); de predominance feminine (87); sans terrain predisposant. Le tableau clinique etait toujours celui d'une peritonite. L'exploration chirurgicale a ete menee 13 fois par laparotomie et 2 fois par laparoscopie. Une triple antibiotherapie probabiliste completait systematiquement ce geste. Elle comprenait une cephalosporine ou une beta-lactamine; un aminoside et du metronidazole. Cette association peu commune permettait une antibiotherapie a large spectre peu couteuse. Les bacilles gram negatif etaient; comme chez le cirrhotique; les germes les plus retrouves (47). Streptoco- ccus pneumoniae a ete retrouve dans 40des cas. Des foyers infectieux ORL et pulmonaires ont parfois ete suspectes.Malgre l'absence de documentation bacteriologi-que genitale; la frequente implication de pneumocoque et l'age de la population evoqueraient une contamination par voie gynecologique chez les jeunes filles. Cette etude presente des aspects epidemiologiques; cliniques et bacteriologiques inhabituels. En Europe; la chirurgie peut etre evitee grace a l'accessibilite des examens complemen- taires de qualite. En Afrique; les bases du traitement reposeraient sur l'antibiotherapie et la toilette peritoneale. La laparoscopie serait la voie d'abord a privilegier

Peritonites primitives en Afrique subsaharienne : a propos de 15 cas

La peritonite primitive (PP) est une infection du peritoine sans etiologie septique intraperitoneale. Souvent decrite chez le cirrhotique; elle est rare chez le sujet sain. Nous rapportons une etude retrospective sur 3 ans de 15 cas pris en charge a l'Hopital Principal de Dakar. Tous les patients ont ete operes. Les prelevements bacteriologiques per-operatoires ont ete systematiques. La population etait jeune (2 patients avaient plus de 13 ans); de predominance feminine (87); sans terrain predisposant. Le tableau clinique etait toujours celui d'une peritonite. L'exploration chirurgicale a ete menee 13 fois par laparotomie et 2 fois par laparoscopie. Une triple antibiotherapie probabiliste completait systematiquement ce geste. Elle comprenait une cephalosporine ou une beta-lactamine; un aminoside et du metronidazole. Cette association peu commune permettait une antibiotherapie a large spectre peu couteuse. Les bacilles gram negatif etaient; comme chez le cirrhotique; les germes les plus retrouves (47). Streptococcus pneumoniae a ete retrouve dans 40des cas. Des foyers infectieux ORL et pulmonaires ont parfois ete suspectes.Malgre l'absence de documentation bacteriologique genitale; la frequente implication de pneumocoque et l'age de la population evoqueraient une contamination par voie gynecologique chez les jeunes filles. Cette etude presente des aspects epidemiologiques; cliniques et bacteriologiques inhabituels. En Europe; la chirurgie peut etre evitee grace a l'accessibilite des examens complementaires de qualite. En Afrique; les bases du traitement reposeraient sur l'antibiotherapie et la toilette peritoneale. La laparoscopie serait la voie d'abord a privilegier

Polymerase Chain Reaction Assay and Bacterial Meningitis Surveillance in Remote Areas; Niger

To compensate for the lack of laboratories in remote areas; the national reference laboratory for meningitis in Niger used polymerase chain reaction (PCR) to enhance the surveillance of meningitis caused by Neisseria meningitidis; Streptococcus pneumoniae; and Haemophilus influenzae. PCR effectively documented the wide geographic spread of N. meningitidis serogroup W135

Prevalence and risk factors for nasopharyngeal carriage of streptococcus pneumoniae in Lira Municipality

"Streptococcus pneumoniae causes more than half of episodes of pneumonia in developing countries. It is the most common cause of Otitis media in children; and of Meningitis in adults. Over the last decades; resistance of this organism to penicillin and other drugs has emerged and been reported world wide; including Uganda. High nasopharyngeal carriage rates of up to 60have been reproted; the peak being in children below two years of age. Invasive disease often results from colonization of this site in children; the elderly and debilitated persons. Risk factors for carriage have been shown to be good predictors for invasive disease. Studies done in europe and USA have identified some factors associated with increased risk of pneumococcal carriage and drug resistance. In developing countries; such as Uganda; the magnitude of carriage; risk factors for resistance to drugs and sensitivity patterns are not well documented. A study done in Kampala; Uganda; documented high carriage rates in children but risk factors were not adequately explored. A cross sectional study was done in Lira Municipality to determine the prevalence of nasopharyngeal carriage; define the potential risk factors for carriage and resistance to five selected antibiotics. Thirty local Council 1 villages were selected at random to form ""clusters"" of households. Seven households were then selected at random and children aged four years and below living in these households were eligible for recruitment. Data on socio -demographic and risk factors were collected by trained field assistants using close ended; and open handed questionnaires administered to each subject. Laboratory samples were obtained by swabbing the nasopharynx of study subject with sterile aluminum swabs and immediately inoculating these on 5human blood agar media. Identification of pneumococci was based on sensitivity to optchin. Tests for susceptibility were done on Mueller-Hinton medium; using the disk diffusion method and diameters of zone of growth inhibition compared to a standard (NCCLS) table of zone diameter breakpoints (in mm). Data was entered; cleaned and analysed using EPI Info package in the Institute of Public Health. One hundred and eighty seven children were sampled. Mean age was 17.2 months; range 7 weeks to 48 months; standard deviation of 11.47 months. There were 91(48.7) girls and 96 (51.3) girls. Pneumococci were recovered from 90 (48.1) of the girls; but this was not significant (X2"