Pneumococcal infections at a rural tertiary care hospital: a seven year study on isolation rate, clinical spectrum and antibiogram.

BACKGROUND Invasive pneumococcal infections such as pneumonia, bacteraemia and meningitis are severe and often fatal. In recent years, pneumococcal resistance to penicillin has been a problem in many countries. We, in this retrospective study analysed the case records of culture proven pneumococcal infections seen over a period of seven at a rural tertiary health care centre in Karnataka and studied the antibiotic resistance pattern of the isolates. AIMS To know the spectrum of illness caused by pneumococci, isolation rate from the specimens and the antibiogram of pneumococci isolated from patients admitted at a rural tertiary care centre. METHODS The laboratory records were searched for isolations of pneumococci from different samples from 2006-2012. The isolation rate from different specimens was calculated. The case records of the patients whose samples yielded pneumococci were analysed for demographic and clinical details. The antibiotic sensitivity pattern of the isolates was studied. RESULTS During the study period of seven, pneumococci were isolated from 34 (0.092%) of the 37,070 samples processed. Samples of blood, pleural fluid, sputum and CSF obtained from patients with bacteraemia, community acquired pneumonia and meningitis accounted for 31(91.2%) of the 34 pneumococcal isolations. All the isolates (100%) were sensitive to penicillin; they were also sensitive to erythromycin, chloramphenicol, vancomycin and linezolid. The sensitivity to gentamicin, ciprofloxacin and tetracycline varied from 79.4% to 88.2%. Only 50% of the isolates were sensitive to cotrimoxazole. Among the patients who yielded pneumococci, 21(61.76%) were children. The patients were treated with a combination of β-lactam and aminoglycoside aminoglycoside antibiotics. Eighteen (90%) of the 20 patients, whose outcome was known, recovered completely. CONCLUSION Majority of the isolations of pneumococci over a period of seven were made from samples obtained from patients with invasive pneumococcal diseases such as community acquired pneumonia, bacteraemia and meningitis. Children contributed 2/3(rd) of the pneumococcal isolations. All the isolates were sensitive to penicillin, erythromycin, chloramphenicol, vancomycin and linezolid, where as 50% of the isolates were resistant to cotrimoxazole. Ninety percent of the patients recovered completely after appropriate antibiotic therapy.