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Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15.
J Antimicrob Chemother. 2016 May; 71 Suppl 1:i103-9.JA

Abstract

OBJECTIVES

To investigate changes in the antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2015 in Pakistan.

METHODS

This is a review based on previously published studies from 2002-03, 2004-06 and 2007-09 and also new data from 2014-15. Susceptibility was determined by Etest(®) or disc diffusion according to CLSI and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.

RESULTS

A total of 706 isolates from CA-RTIs comprising 381 S. pneumoniae, 230 H. influenzae and 95 S. pyogenes were collected between 2002 and 2015 and tested against a range of antibiotics. Antibiotic resistance in S. pneumoniae rose steeply from 2002 to 2009, with isolates non-susceptible to penicillin and macrolides increasing from 10% to 34.1% and from 13%-14% to 29.7%, respectively. Susceptibility to amoxicillin/clavulanic acid (and by inference amoxicillin) remained between 99.4% and 100% from 2002 to 2015. Over the years, the prevalence of susceptibility to cefuroxime was 98%-100% among S. pneumoniae. Resistance in S. pneumoniae to some older antibiotics between 2007 and 2009 was high (86.8% for trimethoprim/sulfamethoxazole and 57.2% for tetracycline). Between 2002 and 2015, ampicillin resistance (β-lactamase-positive strains) among H. influenzae has remained low (between 2.6% and 3.2%) and almost unchanged over the years (H. influenzae was not tested during 2004-06). For S. pyogenes isolates, macrolide resistance reached 22%; however, susceptibility to penicillin, amoxicillin/clavulanic acid and cefuroxime remained stable at 100%.

CONCLUSIONS

In S. pneumoniae from Pakistan, there has been a clear reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (amoxicillin) or cefuroxime. However, susceptibility in H. influenzae has remained stable. Local antibiotic susceptibility/resistance data are essential to support informed prescribing for CA-RTIs and other infections.

Authors+Show Affiliations

Aga Khan University Hospital, Department of Pathology and Laboratory Medicine, Section of Microbiology, Karachi, Pakistan.Aga Khan University Hospital, Department of Pathology and Laboratory Medicine, Section of Microbiology, Karachi, Pakistan.Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan.Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan.Shaukat Khanum Memorial Cancer Hospital and Research Center, Department of Microbiology, 7A, Block R-3, Johar Town, Lahore, Pakistan.GlaxoSmithKline Pakistan, 35 Dockyard Road, West Wharf, Karachi 74000, Pakistan.IHMA Europe Sàrl, 9a route de la Corniche, Epalinges 1066, Switzerland.GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK.GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27048578

Citation

Zafar, A, et al. "Antibiotic Susceptibility in Streptococcus Pneumoniae, Haemophilus Influenzae and Streptococcus Pyogenes in Pakistan: a Review of Results From the Survey of Antibiotic Resistance (SOAR) 2002-15." The Journal of Antimicrobial Chemotherapy, vol. 71 Suppl 1, 2016, pp. i103-9.
Zafar A, Hasan R, Nizamuddin S, et al. Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother. 2016;71 Suppl 1:i103-9.
Zafar, A., Hasan, R., Nizamuddin, S., Mahmood, N., Mukhtar, S., Ali, F., Morrissey, I., Barker, K., & Torumkuney, D. (2016). Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. The Journal of Antimicrobial Chemotherapy, 71 Suppl 1, i103-9. https://doi.org/10.1093/jac/dkw076
Zafar A, et al. Antibiotic Susceptibility in Streptococcus Pneumoniae, Haemophilus Influenzae and Streptococcus Pyogenes in Pakistan: a Review of Results From the Survey of Antibiotic Resistance (SOAR) 2002-15. J Antimicrob Chemother. 2016;71 Suppl 1:i103-9. PubMed PMID: 27048578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002-15. AU - Zafar,A, AU - Hasan,R, AU - Nizamuddin,S, AU - Mahmood,N, AU - Mukhtar,S, AU - Ali,F, AU - Morrissey,I, AU - Barker,K, AU - Torumkuney,D, PY - 2016/4/7/entrez PY - 2016/4/7/pubmed PY - 2016/12/15/medline SP - i103 EP - 9 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 71 Suppl 1 N2 - OBJECTIVES: To investigate changes in the antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2015 in Pakistan. METHODS: This is a review based on previously published studies from 2002-03, 2004-06 and 2007-09 and also new data from 2014-15. Susceptibility was determined by Etest(®) or disc diffusion according to CLSI and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS: A total of 706 isolates from CA-RTIs comprising 381 S. pneumoniae, 230 H. influenzae and 95 S. pyogenes were collected between 2002 and 2015 and tested against a range of antibiotics. Antibiotic resistance in S. pneumoniae rose steeply from 2002 to 2009, with isolates non-susceptible to penicillin and macrolides increasing from 10% to 34.1% and from 13%-14% to 29.7%, respectively. Susceptibility to amoxicillin/clavulanic acid (and by inference amoxicillin) remained between 99.4% and 100% from 2002 to 2015. Over the years, the prevalence of susceptibility to cefuroxime was 98%-100% among S. pneumoniae. Resistance in S. pneumoniae to some older antibiotics between 2007 and 2009 was high (86.8% for trimethoprim/sulfamethoxazole and 57.2% for tetracycline). Between 2002 and 2015, ampicillin resistance (β-lactamase-positive strains) among H. influenzae has remained low (between 2.6% and 3.2%) and almost unchanged over the years (H. influenzae was not tested during 2004-06). For S. pyogenes isolates, macrolide resistance reached 22%; however, susceptibility to penicillin, amoxicillin/clavulanic acid and cefuroxime remained stable at 100%. CONCLUSIONS: In S. pneumoniae from Pakistan, there has been a clear reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (amoxicillin) or cefuroxime. However, susceptibility in H. influenzae has remained stable. Local antibiotic susceptibility/resistance data are essential to support informed prescribing for CA-RTIs and other infections. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/27048578/Antibiotic_susceptibility_in_Streptococcus_pneumoniae_Haemophilus_influenzae_and_Streptococcus_pyogenes_in_Pakistan:_a_review_of_results_from_the_Survey_of_Antibiotic_Resistance__SOAR__2002_15_ DB - PRIME DP - Unbound Medicine ER -