Carriage of Antibiotic-Resistant Streptococcus pneumoniae in Greek Infants and Toddlers

Abstract

The prevalence, resistance patterns and serotypes of antibiotic-resistant Streptococcus pneumoniae strains recovered from Greek carriers under 24 months of age were studied. From February 1997 to April 1998, nasopharyngeal cultures were performed in 1,269 children (ages 2-23 months, median 11 months) living in various areas of central and southern Greece. Resistance (including both intermediate and resistant isolates) to one or more antimicrobial agents was found in 132 of the 421 (31%) Streptococcus pneumoniae isolates, as follows: penicillin, 9% intermediate, 7.6% resistant; cefotaxime, 5.2% intermediate, 0.5% resistant; erythromycin, 0.7% intermediate, 18.1% resistant; clindamycin, 0.2% intermediate, 12.4% resistant; tetracycline, 0.7% intermediate, 16.4% resistant; chloramphenicol, 12.4% resistant; and trimethoprim-sulfamethoxazole, 3.8% intermediate, 14.3% resistant. The MICs of penicillin for 66% of the penicillin-nonsusceptible pneumococci were 1-4 microg/ml. Multidrug resistance was found in 64% of penicillin-nonsusceptible and 37% of penicillin-susceptible strains. Sixty-two percent of the penicillin-susceptible, multidrug-resistant strains belonged to serotype 6B and were resistant to all five non-beta-lactam agents tested. This notable serotype 6B resistance pattern was described for the first time in a previous study performed from December 1995 to February 1996 in the city of Patras, southwestern Greece. Seventy-two percent of antibiotic-resistant isolates belonged to serotypes 6B, 9V, 14, 18C, 19F and 23F. These results document the spread of resistant pneumococcal strains in central and southern Greece, many of which are multidrug resistant.

Deletion of arcD in Streptococcus pneumoniae D39 Impairs Its Capsule and Attenuates Virulence

“…Noticeably, ST556 and its ⌬arcD mutant both exhibited even greater colonization than the D39 ⌬arcD mutant. ST556 belongs to serotype 19F, and bacteria of this serotype are commonly isolated as carriage strains (55). The increased adherence of the D39 ⌬arcD mutant can be explained by its impaired capsule, which is consistent with the observations by comparison Titration of arginine concentrations in CDM.…”

Social-economic factors and irrational antibiotic use as reasons for antibiotic resistance of bacteria causing common childhood infections in primary healthcare

“…The rationalization of antibiotic utilization decreased antibiotic resistance levels multiresistant strains (23 F, 19 F, 6A and 14) was detected in 31% of isolates. These strains were similar to the ones isolated in Singapore during the same period [78,82], suggesting that in the era of intense migration and exchange of goods, the bacterial infection spread despite a considerable geographic distance.…”

Nasopharyngeal carriage, antimicrobial susceptibility, serotype distribution and clonal relatedness of isolates in healthy children in Malatya, Turkey

“…The percentages of intermediate and high-level penicillin resistance were 41% and 4%, respectively, in Brazil [21], and 32.1% and 26.1%, respectively, in Hong Kong [20]. The frequencies of intermediate and high-level penicillin resistance were 9% and 7.6%, respectively, and erythromycin resistance was 18.1% in Greek children [25]. Similar results were observed in the area of Bari, Italy, where 18.3% of healthy children were S. pneumoniae carriers and 8.6% of the strains were intermediately resistant to penicillin, but they had a high resistance rate (65.5%) to erythromycin [1].…”