title: Serotype distribution and prevalence of resistance to benzylpenicillin in three representative populations of Streptococcus pneumoniae isolates from the coast of Kenya.
abstract: As surveillance data from sub-Saharan Africa are few, three representative populations of Streptococcus pneumoniae isolates were examined in Kenya for serotype distribution and Etest minimum inhibitory concentrations (MICs) of benzylpenicillin: (1) 75 lung aspirate or blood culture isolates from 301 consecutive adult patients with pneumonia, (2) 112 invasive isolates from continuous pediatric inpatient surveillance over 4 years, and (3) 97 nasopharyngeal isolates from systematically selected sick children. The proportions with benzylpenicillin MICs of > or = 0.1 microgram/mL were 0.27, 0.29, and 0.47, respectively. Vaccine-related serotypes accounted for 96% of invasive isolates from children and 90% of those from human immunodeficiency virus (HIV)-seropositive adults. Serotype 1 accounted for 44% of pneumococci from HIV-seronegative patients but only 5% of those from HIV-seropositive patients (P = .0002). Of serotype 1 isolates, 98% were susceptible to benzylpenicillin, but serogroups 13, 14, 19, and 23 were strongly associated with an MIC of > or = 0.1 microgram/mL.
authors.affiliation: Kenya Medical Research Institute, CRC, Kilifi Research Unit, Kenya.
authors.forename: J A
authors.initials: JA
authors.lastname: Scott
authors.forename: A J
authors.initials: AJ
authors.lastname: Hall
authors.forename: A
authors.initials: A
authors.lastname: Hannington
authors.forename: R
authors.initials: R
authors.lastname: Edwards
authors.forename: S
authors.initials: S
authors.lastname: Mwarumba
authors.forename: B
authors.initials: B
authors.lastname: Lowe
authors.forename: D
authors.initials: D
authors.lastname: Griffiths
authors.forename: D
authors.initials: D
authors.lastname: Crook
authors.forename: K
authors.initials: K
authors.lastname: Marsh
mesh_terms: D000328:Adult; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D010400:Penicillin G / Q000494:pharmacology*; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D011018:Pneumonia, Pneumococcal / Q000382:microbiology; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects
chemical_list: D010406:Penicillins; D010400:Penicillin G