Table 4.
Changes in Antibiotic Susceptibility Among Pneumococcal Strains Identified From Carriers Before (2009) and After (2013) 10-Valent Pneumococcal Conjugate Vaccine Introduction
| Susceptible | Intermediate | Resistant | |||||
|---|---|---|---|---|---|---|---|
| Antibiotic and Year | Break Point (μg/mL) | n (%) | Break Point (μg/mL) | n (%) | Break Point (μg/mL) | n (%) | P Value (2009 vs 2013) |
| Pneumococcal isolates from Kibera children aged <5 years (N = 499 in 2009, N = 445 in 2013) | |||||||
| Penicillin | |||||||
| 2009 | ≤0.06 | 100 (20.0) | 0.12–1 | 387 (77.6) | ≥2 | 12 (2.4) | .618 |
| 2013 | … | 100 (22.5) | … | 333 (74.8) | … | 12 (2.7) | … |
| Chloramphenicol | |||||||
| 2009 | ≤4 | 490 (98.2) | NA | … | ≥8 | 9 (1.8) | .182 |
| 2013 | … | 431 (96.9) | … | … | … | 14 (3.2) | … |
| Levofloxacin | |||||||
| 2009 | ≤2 | 499 (100) | 4 | 0 | ≥8 | 0 | NA |
| 2013 | … | 445 (100) | … | 0 | … | 0 | … |
| Erythromycin | |||||||
| 2009 | ≤0.25 | 490 (98.2) | 0.5 | 1 (0.2) | ≥1 | 8 (1.6) | .042 |
| 2013 | … | 428 (96.2) | … | 0 | … | 17 (3.8) | … |
| Ceftriaxone | |||||||
| 2009 | ≤1 | 499 (100) | 2 | 0 | ≥4 | 0 | .005 |
| 2013 | … | 438 (98.4) | … | 7 (1.6) | … | 0 | … |
| Tetracycline | |||||||
| 2009 | ≤2 | 401 (80.4) | 4 | 13 (2.6) | ≥8 | 85 (17.0) | .187 |
| 2013 | … | 377 (84.7) | … | 11 (2.5) | … | 57 (12.8) | … |
| Cotrimoxazole | |||||||
| 2009 | ≤0.5/9.5 | 15 (3.0) | 1/19–2/38 | 54 (10.8) | ≥4/76 | 430 (86.2) | .029 |
| 2013 | … | 17 (3.8) | … | 27 (6.1) | … | 401 (90.1) | … |
| Clindamycin | |||||||
| 2009 | ≤0.25 | 498 (99.8) | 0.5 | 0 | ≥1 | 1 (0.2) | .001 |
| 2013 | … | 433 (97.3) | … | 0 | … | 12 (2.7) | … |
| Pneumococcal isolates from Lwak children aged <5 years (N = 163 in 2009, N = 181 in 2013) | |||||||
| Penicillin | |||||||
| 2009 | ≤0.06 | 27 (16.6) | 0.12–1 | 133 (81.6) | ≥2 | 3 (1.8) | .235 |
| 2013 | … | 31 (17.1) | … | 150 (82.3) | … | 0 | … |
| Chloramphenicola | |||||||
| 2009 | ≤4 | 153 (97.5) | N/A | … | ≥8 | 4 (2.6) | .757 |
| 2013 | … | 175 (96.7) | … | … | … | 6 (3.3) | … |
| Levofloxacina | |||||||
| 2009 | ≤2 | 157 (100) | 4 | 0 | ≥8 | 0 | NA |
| 2013 | … | 181 (100) | … | 0 | … | 0 | … |
| Erythromycin | |||||||
| 2009 | ≤0.25 | 162 (99.4) | 0.5 | 0 | ≥1 | 1 (0.6) | .474 |
| 2013 | … | 181 (100) | … | 0 | … | 0 | … |
| Ceftriaxone | |||||||
| 2009 | ≤1 | 163 (100) | 2 | 0 | ≥4 | 0 | NA |
| 2013 | … | 181 (100) | … | 0 | … | 0 | … |
| Tetracycline | |||||||
| 2009 | ≤2 | 131 (80.4) | 4 | 2 (1.2) | ≥8 | 30 (18.4) | .001 |
| 2013 | … | 143 (79.0) | … | 17 (9.4) | … | 21 (11.6) | … |
| Cotrimoxazoleb | |||||||
| 2009 | ≤0.5/9.5 | 0 | 1/19–2/38 | 9 (5.6) | ≥4/76 | 152 (94.4) | 1.000 |
| 2013 | … | 0 | … | 10 (5.5) | … | 171 (94.5) | … |
| Clindamycin | |||||||
| 2009 | ≤0.25 | 163 (100) | 0.5 | 0 | ≥1 | 0 | NA |
| 2013 | … | 181 (100) | … | 0 | … | 0 | … |
| Pneumococcal isolates from HIV-positive adults (N = 199 in 2009, N = 150 in 2013) | |||||||
| Penicillin | |||||||
| 2009 | ≤0.06 | 33 (16.6) | 0.12–1 | 162 (81.4) | ≥2 | 4 (2.0) | .549 |
| 2013 | … | 32 (21.3) | … | 116 (77.3) | … | 2 (1.3) | … |
| Chloramphenicol | |||||||
| 2009 | ≤4 | 196 (98.5) | N/A | … | ≥8 | 3 (1.5) | .181 |
| 2013 | … | 144 (96.0) | … | … | … | 6 (4.0) | … |
| Levofloxacin | |||||||
| 2009 | ≤2 | 199 (100) | 4 | 0 | ≥8 | 0 | NA |
| 2013 | … | 150 (100) | … | 0 | … | 0 | … |
| Erythromycin | |||||||
| 2009 | ≤0.25 | 197 (99.0) | 0.5 | 0 | ≥1 | 2 (1.0) | 1.000 |
| 2013 | … | 148 (98.7) | … | 0 | … | 2 (1.3) | … |
| Ceftriaxone | |||||||
| 2009 | ≤1 | 199 (100) | 2 | 0 | ≥4 | 0 | NA |
| 2013 | … | 150 (100) | … | 0 | … | 0 | … |
| Tetracyclinec | |||||||
| 2009 | ≤2 | 150 (75.8) | 4 | 8 (4.0) | ≥8 | 40 (20.2) | .534 |
| 2013 | … | 109 (72.7) | … | 10 (6.7) | … | 31 (20.7) | … |
| Cotrimoxazolec | |||||||
| 2009 | ≤0.5/9.5 | 1 (0.5) | 1/19–2/38 | 6 (3.1) | ≥4/76 | 190 (96.5) | .474 |
| 2013 | … | 0 | … | 2 (1.3) | … | 148 (98.7) | … |
| Clindamycin | |||||||
| 2009 | ≤0.25 | 198 (99.5) | 0.5 | 0 | ≥1 | 1 (0.5) | .579 |
| 2013 | … | 148 (98.7) | … | 0 | … | 2 (1.3) | … |
Abbreviations: HIV, human immunodeficiency virus; NA, not applicable.
a
Six isolates in 2009 were missing susceptibility testing results for both chloramphenicol and levofloxacin.
b
Two isolates in 2009 were missing susceptibility testing results for cotrimoxazole only.
c
One isolate from 2009 was missing susceptibility testing results for both tetracycline and cotrimoxazole; 1 isolate from 2009 was missing susceptibility testing results for cotromixazole only.