Type frequency and antimicrobial sensitivity pattern of URT isolates in children – 2017- 2018

From fall 2017- fall 2018, of 820 nose culture requested 246 (30%) grew normal flora and 574(70%) grew isolates considered pathogens- Positivity rate of 70%. Out of 542 True pathopgens; 182 (33.5%) were M. catarrhalis, 108 (20%) H. influ. 87 (16%) staph. Coag. + ve, 79 (14.5%) S. Pneumoniae, 67(12.3%) S.Viridans, 13 (2.3%), GABHS & 6(1.1%) BHS not A. concurrently, out of 59 throat cultures 43 (73%) were positive for pathogens and 16 (27%) normal flora. the main pathogens isolated from throat were GABHS–27 (65.8%). Other steptococci. Included- GBBHS 2, GGBHS 2, GFBHS 1 & Unidentified BHS not A 9. Seasonal distribution of isolates showed that M. Catarrhalis is more Common during cold seasons- 142 (78%) VS 40 (22%) in warm seasons. H. influ. 69% in cold seasons vs 27% in warm seasons. Staph. Coag. +ve showed the lowest distribution in winter- 19.5% & highest – 47% in spring & summer. S. Pneumoniae mainly isolated in winter & spring- 80%, and summer & falls- 20%. Beta – hemolytic streptococci mainly GABHS, have highest distribution in winter & spring – 63.3% vs 36.6% in summer & falls. Antimicrobial sensitivity pattern of bacteria isolated from URT reveals: 1. S. Pneumoniae: A. Penicillin Sensitivity: MIC  0.1 – Sensitive 10.8% ,  from 70.8% in 2011 MIC 0.1-1- intermediate 50%,  from 25% in 2011 MIC  39.1  from 4.2% in 2011 B. Cephalexin sensitivity down from 100% in 2011 to 80% 2018. C. Sensitivity of S. Pneumoniae to macrolid antibiotics & cotrimoxazole, is now as low as 10%. D. cefuroxime axetil has 83.3%, clindamycin 3.7% & cefixime 66% Sensitivity for S. Pneumoniae. 2. Pattern of Sensitivity for S. Viridans, GABHS & Beta- hemolytic streptococci not A groups are as follows; All are 100% penicillin sensitive but 80% cephalexin sensitive. For macrolid antibiotics sensitivity is from 10-20% and for cotrimoxazole under 10%. for clindamycin from 30- 50% and for cefuroxime around 100%. 3. H. influ. & Moraxella, although are around 100% sensitive to coamoxiclave and cefuroxime, but 25- 30% for macrolid antibiotics. H. Influ. has sensitivity of around 25% to ampicillin & clinda and 45% to cotrimoxazole, Moraxella is totally reistant to Ampicillin / cephalexin / contrimoxazole and clinda.