Waheed Uz Zaman Tariq, Awatef Abou Hassanein, Rayhan Hasan Hashmey.
Changes in susceptibility pattern of streptococcus pneumonia at Tawam hospital in Al ain , United Arab Emirates during (2004-2011).
Pak Armed Forces Med J Jan ;66(1):14-21.

Objective: Objective of the study was to find out the prevalence and antimicrobial susceptibility pattern of Streptococcus pneumoniae isolates at local hospital. Study Design: Retrospective study. Place and Duration of Study: Microbiology department of Tawam hospital isolates from 2004-2011. Material and Methods: A total of 1066 isolates of Streptococcus pneumoniae were obtained from various clinical specimens at Microbiology section of Department of Laboratory Medicine, Tawam hospital, Al Ain, United Arab Emirates, from the period stretching over eight calendar years; 2004- 2011. We examined the data of all the S. pneumoniae isolates from the different body sites since 2004 until 2011, there were changes in the antibiotic susceptibility interpretation of S. pneumoniae to some antibiotics especially penicillin and ceftriaxone. For this study purpose, the 2011 CLSI guidelines is used retrospectively to interpret the antibiotics susceptibility for all the isolates (2004-2011). Results: The total number of isolates per year remained stable (p = 0.957). The number of isolates from blood showed a significant increase (p<0.05). During the period (2009-2011), most of the isolates were from the pediatric patients (<1–15 years of age) and the elderly (51-95 years old). The isolates were fully sensitive to levofloxacin and vancomycin. There was no significant change in sensitivity to tetracycline, and trimethoprim/ sulphamethaxazole. Until 2010, there was a significant drop in sensitivity to erythromycin (p=0.001, OR= 0.8). In 2011, though insignificant, susceptibility dropped to 47.4%. There was a significant drop in sensitivity to chloramphenicol (p<0.05, OR 1.2) and clindamycin (p<0.05, OR =0.7). Only 41.3% isolates were sensitive to penicillin G (meningitis) in 2004, which remained fairly the same until 2011, when it was 40.2%. In case of other body sites, the isolates sensitive to penicillin G (non- meningitis) were 98.4% in 2004 and 98.3% in 2011. The sensitivity to ceftriaxone (meningitis) dropped significantly from 93.3% to 81.2%. (p<.001 and OR=0.7). The isolates sensitivity to ceftriaxone (non-meningitis) dropped significantly as well from 99.2% in 2004 and 96.6 % in 2011 (p=.014, OR=0.6). There was no significant change in reduced sensitivity to penicillin G for meningitis and non-meningitis. There was a significant increase in the intermediate sensitivity of S. pneumoniae isolates to ceftriaxone (meningitis) from 5.8% in 2004 to 15.4 % in 2011 (p<.001 and OR= 1.3) and ceftriaxone (non- meningitis) from 0.8% to 3.4 %.( p<.001 andOR=1.4). Conclusions: The resistance of S. pneumoniae to ceftriaxone, erythromycin, chloamphenicol and clindamycin is increasing.

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