High Rate of Transmission of Penicillin-Resistant Streptococcus pneumoniae between Parents and Children

Abstract

Transmission of Streptococcus pneumoniae between children and their parents was evaluated in 29 pairs from 25 families. The serotypes of 35 pneumococcal isolates from 18 (62.1%) of 29 child-parent pairs were identical. Of the 35 isolates, 23 showed intermediate resistance and 10 were fully resistant to penicillin G. PCR indicated that all 35 strains had at least one alteration in penicillin-binding protein genes pbp1a, pbp2x, and pbp2b and 33 strains had macrolide resistance genes mef(A) and/or erm(B). As a result, the PCR patterns of 16 of 18 pairs were identical. Molecular typing by pulsed-field gel electrophoresis showed that 12 pairs were indistinguishable, 3 pairs were closely related, 2 pairs were possibly related, and only one pair was different. Our data indicate the presence of a high rate of transmission of penicillin-resistant S. pneumoniae between children and their parents.Streptococcus pneumoniae, which can colonize the human nasopharynx, is a leading bacterial cause of pneumonia, as well as otitis media, sinusitis, septicemia, and meningitis (10). Especially, children are frequent carriers of pneumococci, which may lead to invasive pneumococcal disease (5, 6). Penicillinresistant S. pneumoniae (PRSP) is widespread all over the world, and the resistance is broadening to include other antimicrobial agents (1, 9, 15). It has been reported that children could acquire PRSP at child care centers (13) or from their siblings (14). However, the problem of whether PRSP colonizing the upper respiratory tract can be transmitted between children and parents and cause invasive diseases is not clear. To address this issue, we conducted the following prospective study.New patients with invasive infections (e.g., pneumonia, sinusitis, otitis media, etc.) caused by S. pneumoniae who visited Nagasaki University Hospital or the Sugita Otorhinolaryngologic Clinic from January 2000 to May 2001 were asked to bring their family as soon as possible for clinical examination and collection of biological specimens (e.g., sputum, nasopharynx, middle ear). To diagnose invasive disease caused by pneumococci, gram-stained smears and cultures of good-quality specimens, according to the criteria of Bartlett (2), that were obtained as recently as possible were performed by standard methods. Fifty-four S. pneumoniae isolates from 29 pairs of children (mean age, 1.7 years) and their parents (mean age, 31.5 years) in 25 families were evaluated. We collected two isolates from each of 21 families and three isolates from each of 4 families. Culture plates were incubated overnight in a 5% CO 2 incubator. Optochin sensitivity and bile solubility tests were performed for confirmation of S. pneumoniae. The MICs of penicillin G (Meiji Seika Kaisha, Tokyo, Japan) for 54 S. pneumoniae isolates were determined by the broth microdilution method in accordance with the guidelines of the NCCLS (12). Pneumococci were serotyped on the basis of capsular swelling (Quellung reaction) observed microscopically after suspension in Pneumococcal Diagnostic An...

Clonal Dissemination of Macrolide-Resistant and Penicillin-Susceptible Serotype 3 and Penicillin-Resistant Taiwan 19F-14 and 23F-15 Streptococcus pneumoniae Isolates in Japan: a Pilot Surveillance Study

“…Furthermore, serotypes of 39 Japanese isolates analyzed in the study were not specified, including the Taiwan 19F-14 and Taiwan 23F-15 clones. The SmaI-restricted PFGE patterns of the mef(A)-positive type 19F PRSP Japanese isolates were reported by Hoshino et al (12). Most of the PFGE patterns seemed to be indistinguishable or closely related to the PFGE pattern of Taiwan 19F-14.…”

“…However, information using such molecular techniques is very limited in Japan (12,20,30,34,35). International clonal dissemination of antibiotic-resistant pneumococcal isolates is well documented elsewhere (19,27,30), and the Taiwan 19F-14 clone is one of the representative penicillin-resistant strains in the United States (27).…”

“…Large-scale international surveillance studies such as PROTEKT, SENTRY, Alexander, and the Asian Network for Surveillance of Resistant Pathogens have been ongoing and have revealed that the spread of such multidrug-resistant strains is due mostly to clonal spread; however, it has not yet been ascertained whether this is the case in Japan. So far, no surveillance studies using pulsed-field gel electrophoresis (PFGE) analysis have been conducted in Japan, though some PFGE studies of the Japanese strains of S. pneumoniae are available (12,20,34,35). We therefore carried out a 3-year pilot surveillance study in order to assess how antibiotic-resistant pneumococcal isolates disseminate in Japan.…”

Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Potential Respiratory Pathogens in Adults

“…In most cases colonization causes only a carrier state without producing clinical symptoms, but, if a change occurs in the host's condition, the PRP can cause disease (3). In addition, the bacteria that are carried in the upper respiratory tract can spread from person to person (6,7,10), which is why their presence can provide useful and important information on the emergence of resistance in clinical isolates (8,11).…”

Throat Carrier Rate of Streptococcus pneumoniae among Students Living in Hostels in a Higher Institution

“…In South Africa, 74.5% (35 children out of 47) children with otitis media were due to Streptococcus pneumoniae (Huebner et al, 2003). Several studies have examined household transmission of Streptococcus pneumoniae; most of such studies have suggested that children were the source of transmission to adults in the family (Hoshino et al, 2002;Shimada et al, 2002, Leino et al, 2001. Oniyangi et al, (2006) reported that 60% of HIV/AIDS patient children in Abuja were admitted based on the diagnosis of pneumonia and this disease caused the death of 71.4% of them.…”