Streptococcus pneumoniae Drugs Resistance in Acute Rhinosinusitis

Chong Jie Hao, Chrysanti Chrysanti, Trias Nugrahadi


Background: Acute rhinosinusitis that usually caused by Streptococcus pneumoniae becomes the reason why patients seek for medical care. Drugs resistance in Streptococcus pneumoniae is increasing worldwide. This study was conducted to determine drugs resistance of Streptococcus pneumonia from acute rhinosinusitis in Dr. Hasan Sadikin General Hospital.

Methods: A descriptive laboratory study was conducted in June–October 2014 at the Laboratory of Microbiology Faculty of Medicine Universitas Padjadjaran. The sample was taken using nasopharyngeal swabbing from 100 acute rhinosinusitis patients in Dr. Hasan Sadikin General Hospital and planted on tryptic soy agar containing 5% sheep blood and 5 μg/ml of gentamicin sulphate and then incubated in 5% CO2 incubator at 37°C for 24 hours. The identification of Streptococcus pneumonia was performed by optochin test. The susceptibility test against Streptococcus pneumoniae was done using disk diffusion method.The antibiotic disks were trimethoprim-sulfamethoxazole, oxacillin, levofloxacin, azithromycin, and doxycycline.

Results: Out of 100 samples, 8 of them were tested positive for Streptococcus pneumoniae. Three of Streptococcus pneumoniae isolates died with unknown reason after it were stored at -80 .The drugs resistance test showed the resistance of Streptococcus pneumonia to oxacillin, azithromycin and trimethoprim were 6, whereas levofloxacin and doxycycline are 4.

Conclusions: Streptococcus pneumonia drugs resistance in acute rhinosinusitis shows the resistance of Streptococcus pneumoniae to oxacillin, azithromycin and trimethoprim are 6, whereas the resistance to levofloxacin and doxycycline are 4. [AMJ.2016;3(1):64–8]

DOI: 10.15850/amj.v3n1.722


Acute rhinosinusitis, drugs resistance, Streptococcus pneumoniae

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Benninger M, Woodard T. Microbiology of acute, subacute, and chronic rhinosinusitis in adults. In: Chang CC, Incaudo GA, Gershwin ME, editors. Diseases of the Sinuses: Springer New York; 2014. p. 99 –107.

Mullol, Baroody, Douglas, Goossens, Hopkins, Kalogjera, et al. EPOS 2012: european position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1–12.

Pradana Y, Madiadipoera T, Sudiro M, Dermawan A. Efektivitas imunoterapi terhadap gejala, temuan nasoendoskopik dan kualitas hidup pasien rinosinusitis alergi. Oto Rhino Laryngologica Indonesiana. 2012;42(2): 88–95.

Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, et al. IDSA Clinical Practice Guideline: acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012;54(8):e72–e112.

LU I, EIM H. Acute rhinosinusitis in adults. Am Fam Physician.2011;83:1057–63.

Siow J, Alshaikh N, Balakrishnan A, Chan K, Chao S, Goh L, et al. Ministry of Health Clinical Practice Guidelines: management of rhinosinusitis and allergic rhinitis. Singap Med J. 2010;51(3):190–7.

Lynch III JP, Zhanel GG. Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines.Curr Opin Pulm Med. 2010;16(3):217–25.

Jean, Hsueh. High burden of antimicrobial resistance in Asia. Int J Antimicrob Ag. 2011;37(4):291–5.

WHO. Manual for the laboratory identification and antimicrobial susceptibility testing of bacterial pathogens of public health importance in the developing world. 2003. p. 45–62.

Rubin LG, Rizvi A, Baer A. Effect of swab composition and use of swabs versus swab-containing skim milk-tryptone-glucose-glycerol (STGG) on culture-or PCR-based detection of Streptococcus pneumoniae in simulated and clinical respiratory specimens in STGG transport medium. J Clin Microbiol. 2008;46(8):2635–40.

Hammitt LL, Murdoch DR, Scott JAG, Driscoll A, Karron RA, Levine OS, et al. Specimen collection for the diagnosis of pediatric pneumonia. Clin Infect Dis. 2012;54(suppl 2):S132–S9.

Neves FP, Pinto TC, Corrêa MA, dos Barreto R, de Moreira L, Rodrigues HG, et al. Nasopharyngeal carriage, serotype distribution and antimicrobial resistance of Streptococcus pneumoniae among children from Brazil before the introduction of the 10-valent conjugate vaccine. BMC Infect Dis. 2013;13(1):318.

Kaijalainen T, Ruokokoski E, Ukkonen P, Herva E. Survival of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis frozen in skim milk-tryptone-glucose-glycerol medium. J Clin Microbiol. 2004;42(1):412–4.

Cornejo OE, Rozen DE, May RM, Levin BR. Oscillations in continuous culture populations of Streptococcus pneumoniae: population dynamics and the evolution of clonal suicide. P Roy Soc B-Biol Sci. 2009;276(1659):999–1008.

Liñares J, Ardanuy C, Pallares R, Fenoll A. Changes in antimicrobial resistance, serotypes and genotypes in Streptococcus pneumoniae over a 30‐year period.Clin Microbiol Infec. 2010;16(5):402–10.

Puglisi S, Privitera S, Maiolino L, Serra A, Garotta M, Blandino G, et al. Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis. J Med Microbiol. 2011;60(9):1353–9.

Orr D, Wilkinson P, Moyce L, Martin S, George R, Pichon B. Incidence and epidemiology of levofloxacin resistance in Streptococcus pneumoniae: experience from a tertiary referral hospital in England. J Antimicrob Chemoth. 2010;65(3):449–52.

Patel SN, McGeer A, Melano R, Tyrrell GJ, Green K, Pillai DR, et al. Susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. Antimicrob Agents Ch. 2011;55(8):3703–8.

Varaldo PE, Montanari MP, Giovanetti E. Genetic elements responsible for erythromycin resistance in streptococci. Antimicrob Agents Ch. 2009;53(2):343–53.

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