Nasopharyngeal colonization and penicillin resistance among pneumococcal strains: a Worldwide 2004 update

Abstract

Surveillance of nasopharyngeal pneumococcus has proven to be a valuable tool for the monitoring of antibiotic resistance. We reviewed the latest information on colonization rate and penicillin resistance by making a MEDLINE search, using the terms "nasopharyngeal carriage" and "Streptococcus pneumoniae". Out of 225 articles found, data from 109 recent publications (89% from 1996-2003) were analyzed. Data were reported from 41 countries of six continents. Individuals under the age of five (64.3%) or 10 years (85.7%) were enrolled, including children attending day-care centers (32.1%) or orphanages (3.6%), and healthy individuals (78.6%) or sick patients (43.6%); biological samples were collected mainly by nasopharyngeal swabs (89.3%). The highest colonization rates were reported from Africa (85-87.2%), where several authors did not find high rates of penicillin resistance. On the other hand, studies conducted in North and Central America reported high-level penicillin resistance at rates of approximately 20-30%. Great variation in the rates of pneumococcal colonization and penicillin resistance were observed within regions or continents. There were also considerable differences in similar populations located in different areas of the same country. Data regarding pneumococcal colonization and penicillin resistance are not available from most countries. We also examined the use of antibiotics to treat pneumococcal infections.

High prevalence of children colonized with penicillin-resistant <i>Streptococcus pneumoniae</i> in public day-care centers

“…Entretanto, desde o primeiro caso de isolamento de S. pneumoniae resistente à penicilina, reportado na Austrália em 1967 7 , o aumento da resistência deste microrganismo aos beta-lactâmicos, macrolídeos, tetraciclinas, lincosaminas, cloranfenicol e sulfametoxazol-trimetoprim tem sido descrito em diferentes países, incluindo isolados clínicos e de portadores 8,9 .…”

Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections

“…A pressão antibiótica é diferente para cada droga 64 . Na Espanha, Garcia-Rey et al demonstraram, em 1.684 cepas de S. pneumoniae isoladas de pacientes com infecção respiratória adquirida na comunidade, que a correlação entre uso de antibiótico e resistência bacteriana foi crescente quando foram analisados separadamente penicilinas, cefalosporinas e macrolídeos 76 .…”

Antibioticoterapia ambulatorial como fator de indução da resistência bacteriana: uma abordagem racional para as infecções de vias aéreas

“…63 Although antibiotic resistance has been spreading over recent years, there is great variation between different locations that have been studied, with high and low penicillin resistance rates being reported in nearby geographical regions. 64 This is a very worrying situation, in view of the great ease of transport nowadays, meaning that the movement of people between different areas can rapidly contribute to the dissemination of resistant strains. 65 In Brazil, national surveillance data record that, from 1993 to 2004, the frequency of S. pneumoniae strains resistant to penicillin grew from 10.2% to 27.9%.…”

“…74 Antibiotic pressure is different for each drug. 64 In Spain, Garcia-Rey et al studied 1,684 strains of S.…”