Molecular Diagnosis of Streptococcus Pneumoniae Acute Meningitis and Profile of Sensitivity of Usual Antibiotics in Bangui , Central African Republic

A study was conducted from June 2012 to May 2013 at the National Clinical Biology and Public Health Laboratory (NCBPHL) in Bangui, Central Africa Republic (CAR), on cerebrospinal fluid (CSF) coming from town's hospitals. This study aims to assess the prevalence of Streptococcus pneumoniae strains of and their profile of resistance to antibiotics in CSF. The CSF was collected from patients admitted to the Bangui town's hospitals and suspected of meningitis according to WHO definition of sentinel surveillance protocol (SMR Guide, 2011). On the Basis of number of white blood cells greater than or equal to 5 mL, the CSF was analyzed in the laboratory of the hospital for preliminary tests (cytology, latex agglutination test (LAT) and Gram). An aliquot was transferred into transisolate communities and sent to NCBPHL for confirmation tests by rtPCR, LAT and culture. Susceptibility test was done on strains isolated as recommended by the Antibiogram the Committee of the French Society of Microbiology (CASFM). Microscopic examination after Gram staining performed on 79 samples allowed us to note the presence of germs in 47 samples (25.54%). The bacterial culture has led to the isolation and identification of bacteria in 40 specimens (21.74%). Latex agglutination test was positive for 60 samples (33.33%). The rtPCR performed on the same samples allowed us to register 79 positive samples with a confirmation rate of 42.93%. The report of the biology technique and conventional bacteriology has achieved a score of 50.63%. The results of the antibiogram carried out on S. pneumoniae strains revealed a sensitivity rate of 92.2% to ceftriaxone, 85% to Amoxicillin+clavunique acid, ciprofloxacin and gentamicin. On the contrary, S. pneumoniae strains showed a resistance against Oxacillin (30%) and penicillin (35%). S. pneumoniae is an important cause of invasive disease, especially in children and the elderly. However, the emergence of antibiotic resistant genotypes emphasizes the importance of regulated use of these molecules in order to prevent their evolution.