Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006

Background: Streptococcus pneumoniae and Haemophilus influenzae represent key aetiological agents in respiratory tract infections showing an increasing trend of antimicrobial resistance. We present the first report on the antimicrobial resistance in S. pneumoniae and H. influenzae isolated from pati...

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Main Authors: Abiola Senok, Mansour Al-Zarouni, Jalila Al-Najjar, Abeer Nublusi, Debadatta Panigrahi
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2007-12-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/367
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author Abiola Senok
Mansour Al-Zarouni
Jalila Al-Najjar
Abeer Nublusi
Debadatta Panigrahi
author_facet Abiola Senok
Mansour Al-Zarouni
Jalila Al-Najjar
Abeer Nublusi
Debadatta Panigrahi
author_sort Abiola Senok
collection DOAJ
description Background: Streptococcus pneumoniae and Haemophilus influenzae represent key aetiological agents in respiratory tract infections showing an increasing trend of antimicrobial resistance. We present the first report on the antimicrobial resistance in S. pneumoniae and H. influenzae isolated from patients in the United Arab Emirates. Methods: One hundred S. pneumoniae and 102 H. influenzae strains were isolated from patients with community acquired respiratory tract infections during the study period (October 2004-March 2006). Susceptibility testing to a panel of antibiotics was conducted using disc diffusion and E test. Minimum inhibitory concentrations were interpreted using CLSI and Pharmacokineticpharmacodynamic (PK/PD) breakpoints. Results: For S. pneumoniae isolates, 57% were penicillin susceptible while 98% were susceptible to amoxicillin/clavulanate with both interpretative criteria. Cefaclor was the least effective cephalosporin with only 57% and 43% of isolates showing susceptibility with CLSI and PK/PD breakpoints respectively. Thirty-six isolates were ofloxacin non-susceptible (intermediate and resistant); three resistant isolates were associated with high ciprofloxacin MICs (>8mg/L). There was elevated macrolide resistance with associated high levels of erythromycin/clindamycin cross-resistance (n=22/30) suggesting predominant erm(B)-mediated resistance and 21% of isolates demonstrated multidrug resistance. For H. influenzae, 18% were beta-lactamase producers. Reduction in cefaclor and cefprozil susceptibility with PK/PD breakpoints (94.1% to 41.2% and 62.7% respectively) was seen and only 1% remained azithromycin and clarithomycin susceptible. For both pathogens, lowest susceptibility was with co-trimoxazole. Conclusion: These findings indicate a high level of penicillin resistance and continued usefulness of amoxicillin/clavulanate. Elevated macrolide and fluoroquinolone resistance and the occurrence of multidrug resistance indicate a need for continued surveillance.
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spelling doaj-art-8f070893d7834b4c9c53f3f22903164a2025-08-20T02:57:21ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802007-12-0110310.3855/jidc.367Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006Abiola Senok0Mansour Al-Zarouni1Jalila Al-Najjar2Abeer Nublusi3Debadatta Panigrahi4Department of Clinical Sciences, College of Medicine, University of Sharjah, SharjahAl Qassimi Hospital Laboratory Sharjah, Ministry of HealthAl Qassimi Hospital Laboratory Sharjah, Ministry of HealthAl Qassimi Hospital Laboratory Sharjah, Ministry of HealthDepartment of Clinical Sciences, College of Medicine, University of Sharjah, SharjahBackground: Streptococcus pneumoniae and Haemophilus influenzae represent key aetiological agents in respiratory tract infections showing an increasing trend of antimicrobial resistance. We present the first report on the antimicrobial resistance in S. pneumoniae and H. influenzae isolated from patients in the United Arab Emirates. Methods: One hundred S. pneumoniae and 102 H. influenzae strains were isolated from patients with community acquired respiratory tract infections during the study period (October 2004-March 2006). Susceptibility testing to a panel of antibiotics was conducted using disc diffusion and E test. Minimum inhibitory concentrations were interpreted using CLSI and Pharmacokineticpharmacodynamic (PK/PD) breakpoints. Results: For S. pneumoniae isolates, 57% were penicillin susceptible while 98% were susceptible to amoxicillin/clavulanate with both interpretative criteria. Cefaclor was the least effective cephalosporin with only 57% and 43% of isolates showing susceptibility with CLSI and PK/PD breakpoints respectively. Thirty-six isolates were ofloxacin non-susceptible (intermediate and resistant); three resistant isolates were associated with high ciprofloxacin MICs (>8mg/L). There was elevated macrolide resistance with associated high levels of erythromycin/clindamycin cross-resistance (n=22/30) suggesting predominant erm(B)-mediated resistance and 21% of isolates demonstrated multidrug resistance. For H. influenzae, 18% were beta-lactamase producers. Reduction in cefaclor and cefprozil susceptibility with PK/PD breakpoints (94.1% to 41.2% and 62.7% respectively) was seen and only 1% remained azithromycin and clarithomycin susceptible. For both pathogens, lowest susceptibility was with co-trimoxazole. Conclusion: These findings indicate a high level of penicillin resistance and continued usefulness of amoxicillin/clavulanate. Elevated macrolide and fluoroquinolone resistance and the occurrence of multidrug resistance indicate a need for continued surveillance.https://jidc.org/index.php/journal/article/view/367Antimicrobial resistanceStreptococcus pneumoniaeHaemophilus influenzae
spellingShingle Abiola Senok
Mansour Al-Zarouni
Jalila Al-Najjar
Abeer Nublusi
Debadatta Panigrahi
Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
Journal of Infection in Developing Countries
Antimicrobial resistance
Streptococcus pneumoniae
Haemophilus influenzae
title Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
title_full Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
title_fullStr Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
title_full_unstemmed Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
title_short Antimicrobial resistance among Streptococcus pneumoniae and Haemophilus influenzae isolates in the United Arab Emirates: 2004-2006
title_sort antimicrobial resistance among streptococcus pneumoniae and haemophilus influenzae isolates in the united arab emirates 2004 2006
topic Antimicrobial resistance
Streptococcus pneumoniae
Haemophilus influenzae
url https://jidc.org/index.php/journal/article/view/367
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