Table 2.
MIC and susceptibility results for S. pneumoniae isolates
| Country/antimicrobial | n | Susceptibility |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIC (mg/L) |
CLSI |
PK/PD |
EUCAST |
|||||||||
| 50% | 90% | min | max | %S | %I | %R | %S | %S | %I | %R | ||
| Democratic Republic of Congo | ||||||||||||
| azithromycina | 23 | 0.5 | 2 | 0.03 | 16 | 91.3 | 0 | 8.7 | NA | NA | NA | NA |
| cefixime | 23 | 0.25 | 2 | ≤0.015 | 32 | NA | NA | NA | 87.0 | NA | NA | NA |
| cefuroximeb | 23 | 0.5 | 4 | 0.03 | 32 | 78.3 | 8.7 | 13.0 | 78.3 | 30.4 | 34.8 | 34.8 |
| levofloxacin | 23 | 0.25 | 1 | 0.004 | 2 | 100 | 0 | 0 | 100 | 100 | 0 | 0 |
| ofloxacin | 23 | 0.25 | 1 | 0.004 | >32 | 95.7 | 0 | 4.4 | NA | 43.5 | 52.2 | 4.4 |
| penicillin (oral) | 23 | 0.5 | 8 | 0.06 | 32 | 17.4 | 47.8 | 34.8 | NA | 17.4 | 52.2 | 30.4 |
| penicillin (iv) | 23 | 0.5 | 8 | 0.06 | 32 | 69.6 | 17.4 | 13.0 | NA | 52.2–69.6 | NA | NA |
| SXT | 23 | 0.25 | >32 | 0.004 | >32 | 73.9 | 4.4 | 21.7 | 73.9 | 78.3 | 0 | 21.7 |
| erythromycinc | 23 | NT | NT | NT | NT | 87.0 | 4.3 | 8.7 | NA | 87.0 | 0.0 | 13.0 |
| Ivory Coast | ||||||||||||
| AMCd,e | 110 | 0.03 | 0.12 | ≤0.015 | 2 | 100 | 0 | 0 | 100 (100) | NA | NA | NA |
| cefaclor | 110 | 1 | 4 | 0.25 | 64 | 60.0 | 22.7 | 17.3 | 17.3 | 0 | 17.3 | 82.7 |
| cefuroxime | 110 | 0.06 | 0.25 | ≤0.015 | 1 | 100 | 0 | 0 | 100 | 97.3 | 1.8 | 0.9 |
| clarithromycina | 110 | 0.03 | 0.06 | ≤0.015 | 256 | 95.5 | 0 | 4.5 | NA | NA | NA | NA |
| levofloxacin | 110 | 1 | 1 | 0.25 | 8 | 98.2 | 0.9 | 0.9 | 98.2 | 98.2 | 0 | 1.8 |
| ofloxacin | 110 | 2 | 4 | 0.015 | 32 | 86.4 | 9.1 | 4.5 | NA | 1.8 | 93.6 | 4.6 |
| penicillin (oral) | 110 | 0.03 | 0.5 | ≤0.002 | 4 | 70.0 | 25.5 | 4.5 | NA | 70.0 | 28.2 | 1.8 |
| penicillin (iv) | 110 | 0.03 | 0.5 | ≤0.002 | 4 | 98.2 | 1.8 | 0 | NA | 93.7–98.2 | NA | NA |
| SXT | 110 | 0.5 | 4 | 0.015 | 32 | 50.0 | 26.4 | 23.6 | 50.0 | 54.6 | 21.8 | 23.6 |
| erythromycinc | 110 | NT | NT | NT | NT | 96.4 | 1.8 | 1.8 | NA | 93.6 | 4.6 | 1.8 |
| Kenya | ||||||||||||
| amoxicillin | 64 | 0.5 | 2 | ≤0.015 | 16 | 92.2 | 1.6 | 6.2 | 92.2 | NA | NA | NA |
| AMCd,e | 84 | 0.25 | 2 | ≤0.015 | >256 | 95.2 | 1.2 | 3.6 | 95.2 (96.4) | NA | NA | NA |
| azithromycin | 64 | 2 | >256 | 0.25 | >256 | 65.6 | 6.3 | 28.1 | NA | NA | NA | NA |
| ceftriaxone | 84 | 0.25 | 1 | 0.008 | 8 | 96.4 | 1.2 | 2.4 | 96.4 | 82.1 | 15.5 | 2.4 |
| cefuroxime | 84 | 0.25 | 4 | ≤0.015 | 32 | 66.7 | 17.9 | 15.5 | 66.7 | 54.8 | 4.8 | 40.5 |
| chloramphenicol | 64 | 0.25 | >256 | 0.03 | >256 | 68.7 | 0.0 | 31.3 | NA | 73.4 | 0 | 26.6 |
| erythromycina | 64 | 0.25 | >256 | 0.06 | >256 | 64.1 | 3.1 | 32.8 | NA | 64.1 | 3.1 | 32.8 |
| levofloxacin | 20 | 0.5 | 1 | 0.25 | 1 | 100 | 0 | 0 | 100 | 100 | 0 | 0 |
| moxifloxacin | 84 | 0.12 | 0.25 | 0.03 | 0.5 | 100 | 0 | 0 | 100 | 100 | 0 | 0 |
| penicillin (oral) | 84 | 1 | 2 | ≤0.015 | >256 | 19.0 | 60.7 | 20.2 | NA | 19.0 | 69.0 | 4.8 |
| penicillin (iv) | 84 | 1 | 2 | ≤0.015 | >256 | 95.2 | 1.2 | 3.6 | NA | 46.4–95.2 | NA | NA |
| tetracycline | 64 | 8 | 32 | 0.06 | >256 | 46.8 | 1.6 | 51.6 | NA | 46.9 | 1.6 | 51.6 |
| Senegal | ||||||||||||
| AMCd,e | 14 | ≤0.015 | 0.03 | ≤0.015 | 0.03 | 100 | 0 | 0 | 100 (100) | NA | NA | NA |
| cefaclor | 14 | 1 | 2 | 0.12 | 2 | 78.6 | 21.4 | 0 | 42.9 | 0 | 42.9 | 57.1 |
| cefixime | 14 | 0.5 | 2 | 0.12 | 2 | NA | NA | NA | 85.7 | 0 | 0 | 0 |
| cefuroxime | 14 | 0.06 | 0.25 | ≤0.015 | 0.5 | 100 | 0 | 0 | 100 | 92.9 | 7.1 | 0 |
| clarithromycina | 14 | 0.06 | 0.12 | ≤0.015 | 0.12 | 100 | 0 | 0 | NA | NA | NA | NA |
| clindamycin | 14 | 0.12 | 0.25 | 0.06 | 0.25 | 100 | 0 | 0 | NA | NA | NA | NA |
| levofloxacin | 14 | 0.5 | 1 | 0.5 | 1 | 100 | 0 | 0 | 100 | 100 | 0 | 0 |
| ofloxacin | 14 | 2 | 2 | 1 | 2 | 100 | 0 | 0 | NA | 0 | 100 | 0 |
| penicillin (oral) | 14 | 0.03 | 0.12 | ≤0.015 | 0.12 | 85.7 | 14.3 | 0 | NA | 85.7 | 14.3 | 0 |
| penicillin (iv) | 14 | 0.03 | 0.12 | ≤0.015 | 0.12 | 100 | 0 | 0 | NA | 100 | NA | NA |
| SXT | 14 | 4 | 32 | 0.06 | 32 | 14.3 | 28.6 | 57.1 | 14.3 | 21.4 | 21.4 | 57.1 |
| erythromycinc | 14 | NT | NT | NT | NT | 100 | 0 | 0 | NA | 100 | 0 | 0 |
S, susceptible; I, intermediate; R, resistant; NA, no breakpoint data available (NA for azithromycin, clarithromycin and clindamycin by PK/PD and EUCAST and for erythromycin by EUCAST because Etest® breakpoints in CO2 not available); NT, not tested for MIC; SXT, trimethoprim/sulfamethoxazole; AMC, amoxicillin/clavulanic acid.
abioMérieux Etest® breakpoints for incubation in CO2.
bBreakpoints used are for cefuroxime axetil.
cUsing S/I/R zone diameters (mm) of CLSI (≤15/16–20/≥21) and EUCAST (≤18/19–21/≥22).
dAmoxicillin/clavulanic acid PK/PD susceptibility at high dose shown in parentheses.
eFor S. pneumoniae susceptibility to amoxicillin alone can be inferred from amoxicillin/clavulanic acid data.