title: Antimicrobial Susceptibility Pattern of Invasive Pneumococcal Isolates in North West Nigeria.
abstract: BACKGROUND
  An alarming increase in infections due to penicillin non-susceptible pneumococci (PNSP) has been documented in nearly all countries. Increasingly, PNSP are also resistant to other antibiotics, and a growing number of clinical failures following the use of these agents have been reported.
  
  
  OBJECTIVE
  To determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in North West Nigeria.
  
  
  METHODS
  In a cross-sectional study clinical specimens were obtained from patients with community acquired pneumonia (CAP), meningitis and bacteraemia over a 2 year period. Pneumococcus strains were identified. Isolates were tested against a panel of antibiotics using E-test strips, and interpreted according to the CLSI criteria. 0.06 μg/ml was used as break point for penicillin. Analysis was carried out using descriptive statistics; relationships determined using chi-squared or Fisher's exact tests, with P < 0.05 regarded as significant.
  
  
  RESULTS
  Total number of isolates was 132. Twenty-two (16.7%) of the isolates were fully sensitive to penicillin while 73 (55.3%) and 37 (28.0%) were intermediately and fully resistant, respectively. One hundred and twenty-seven (96.2%) of the isolates were fully resistant to trimethoprim-sulphamethoxazole. Eleven (8.5%) were fully resistant to amoxicillin and 104 (78.8%) and 17 (12.9%) were intermediately resistant and fully susceptible. One hundred and six (80.3%) of the isolates were fully susceptible to chloramphenicol. Resistance to penicillin was shown to infer resistance to other antibiotics.
  
  
  CONCLUSIONS
  Pneumococcal resistance is common in North West Nigeria. Ceftriaxone retains excellent activity against most of the invasive isolate, while trimethoprim-sulphamethoxazole is almost uniformly resistant.
authors.affiliation: Department of Medicine, College of Health Sciences, Bayero University Kano, Kano State, Nigeria.
authors.forename: Garba
authors.initials: G
authors.lastname: Lliyasu
authors.affiliation: Department of Medicine, College of Health Sciences, Bayero University Kano, Kano State, Nigeria.
authors.forename: Abdulrazaq G
authors.initials: AG
authors.lastname: Habib
authors.affiliation: Department of Microbiology, Aminu Kano Teaching Hospital, Kano State, Nigeria.
authors.forename: Aminu B
authors.initials: AB
authors.lastname: Mohammad
keywords: Antimicrobial; invasive; pneumococcus; resistance