Antibiotic resistance of Streptococcus pneumonia serotypes in Kisii, Kenya

Abstract Background : Pneumonia remains the leading cause of death in children under five worldwide, accounting for about 1.6 million deaths a year. Streptococcus pneumonia , has proved to be the most competent bacterial pathogen causing pneumonia infections among the infants and the elderly, leading to great morbidity and mortality. Currently there are over 94 different serotypes of Streptococcus pneumonia , and quite a number have emerged as drug-resistant strains which introduce a twist to the current treatment strategies. Detailed information of current antibiotic susceptibilities, resistance and serotype distribution will be important in designing new strategies for treatment and management of pneumococcal infections. Methods: A total of 309 S. pneumoniae isolates were collected from patients attending the Kisii Teaching and Referral Hospital between 2017 and 2018. Nasopharyngeal samples collected and serotyped using PCR. The samples were cultured and their sensitivity to drugs tested using various concentrations of; Oxacilin, Erythromycin, Tetracycline, Ofloxacin, Trimethoprim/sulfamethoxazole and Chloramphenicol. Results: Out of the 309 samples collected, 235 were positive for S. pneumonia, although 10 of the samples had incomplete data. A total of 41 S. pneumonia serotypes isolated from the 309 samples with the most prevalent serotypes being; Non-typable (11%), 15B (7.6%), 19F (7.0%), 19A (6.7%), 23B (5.8%), 23F (5.3%), 6A (4.4%). All the serotypes were highly resistant to Oxacilin, and trimethoprim/sulfamethoxazole, while showing high sensitivity to Erythromycin, Ofloxacin and chloramphenicol. The rate of sensitivity to Tetracycline was 75% with the other 25% showing intermediate sensitivity. Conclusions: The data collected showed a high rate of S. pneumonia (76%) consisting of various serotypes for various ages. The various serotypes isolated showed a marked resistance routinely used antibiotics for patient samples of various ages. The isolated serotypes also consisted of serotypes 19A, 6A, and 5B that are lacking in the pneumococcal vaccine (PCV 10). This data will provide relevant information for a better approach to both clinical treatment, management and prevention of infections with S. pneumonia. Keywords: Streptococcus pneumonia, Antibiotic resistance, serotypes, Drug sensitivity