Carriage of Antibiotic-Resistant Streptococcus pneumoniae by Children in Eastern and Central Europe--A Multicenter Study with Use of Standardized Methods

Abstract

With use of standardized techniques, a study of nasopharyngeal pneumococcal carriage in children in six Central and Eastern European cities was undertaken during the winter of 1993-1994. Nasopharyngeal swab specimens were collected from 954 children (predominantly under the age of 5 years) who were hospitalized or attending outpatient clinics or day-care centers. Susceptibility of isolates was determined by disk diffusion (on Mueller-Hinton agar with 5% sheep blood). Disks containing 1 micrograms of oxacillin were used to screen for susceptibility to penicillin G. Pneumococci were recovered from 258 (27.0%) of the 954 children. A variety of strains were recovered, and most penicillin-resistant strains were ŕesistant to multiple agents. Minimum inhibitory concentrations of penicillin for selected resistant strains were 0.125-8 micrograms/mL. Resistance to penicillin was common in strains from Bulgaria, Romania, and Slovakia. Resistance to erythromycin and chloramphenicol occurred in Bulgarian and Romanian strains. Strains from Poland were all susceptible to penicillin, but many were resistant to tetracycline. Resistance to trimethoprim-sulfamethoxazole was common in Bulgarian, Romanian, and Slovak strains. Czech and Russian strains were predominantly susceptible to antibiotics. Most resistant strains were of serotypes 6, 14, 19, and 23.

Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

“…The presence of multiply-resistant pneumococcal strains among children at a DCC and in household members and members of the surrounding community is of substantial importance because of the potential of these strains to cause invasive disease. 6,[9][10][11][12][13][14][15][16] This study also demonstrates that the risk of carrying multiply-resistant strains of pneumococci is directly related to the administration of antimicrobial therapy in the preceding three to four months. In settings in which a strain is resistant to multiple antimicrobial agents, prevalent antibiotic therapy can result in increased risk of carriage of the drug-resistant strain.…”

“…Persistent carriage was more frequent with these types. On the other hand, persistent nasopharyngeal carriage of single strains was serotype-dependent 6,14,19,23 and occurred more commonly between 5 and 8 months of age. The duration of carriage decreased with the carriage of successive pneumococcal serotypes and hence was inversely correlated with age.…”

“…Los niños que recibieron varios cursos de antimicrobianos, fueron S treptococcus pneumoniae is a leading cause of a variety of diseases including otitis media, bacteremia, pneumonia, meningitis, and other infections among children, individuals with debilitating medical conditions, and the elderly. [1][2][3][4][5][6][7] It is also found as part of the normal nasopharyngeal flora in about 10 to 50% of healthy children, with particularly high rates in those attending daycare centers (DCC). 8 Treatment of most infections remains empirical due to the lack of suitable diagnostic specimens in cases of sinusitis, otitis, and pneumonia.…”

“…8 Treatment of most infections remains empirical due to the lack of suitable diagnostic specimens in cases of sinusitis, otitis, and pneumonia. [4][5][6] Current treatment regimens are based mainly on historical data and on findings in studies of patients infected with fully susceptible strains. However, the emergence of antibiotic-resistant strains of S. Pneumoniae complicates the empirical management of infections.…”

Colonização de orofaringe por Streptococcus pneumoniae em crianças de creches municipais de Taubaté-SP: correlação entre os principais sorotipos e a vacina pneumocócica conjugada heptavalente

“…Apesar de ainda ser controverso, alguns estudos sugerem que haja maior prevalência de colonização quando se estuda a nasofaringe 9,10 . E, ainda, foram incluídas apenas crianças com rinofaringite aguda, o que pode ser considerado, por alguns autores, um fator de risco para colonização 14 .…”