Multiply Resistant Pneumococcus Causing Meningitis: Its Epidemiology Within a Day-Care Centre

Radetsky, MichaelS.; Johansen, T. L.; Lauer, Brian A.; Istre, G R; Parmelee, StevenW.; Wiesenthal, A. M.; Glode, MaryP

doi:10.1016/s0140-6736(81)90184-7

Cited by 155 publications

(55 citation statements)

References 19 publications

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“…Use of child care facilities has been identified as a risk factor for carriage in other studies [20,27,34], but although virtually all children in this study had attended kindergarten, there was a low rate of carriage.…”

Section: Discussioncontrasting

confidence: 52%

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Boost

O'Donoghue

Dooley³

2001

Epidemiol. Infect.

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SUMMARYA cross-sectional survey was conducted to determine prevalence and assess risk factors for carriage of antibiotic resistant strains of Streptococcus pneumoniae in healthy school children in Hong Kong. Throat swabs were collected from 1455 subjects and written questionnaires providing demographic data and medical history were completed by parents. The overall carriage rate of Streptococcus pneumoniae was 3n5 %, of which 49 % were penicillin resistant. High levels of resistance to tetracycline (73 %), erythromycin (52 %), trimethoprim (66 %) and ciprofloxacin (57 %) were observed. Carriage was associated with presence of a younger sibling (OR l 1n79) and use of antibiotics (OR l 2n31). High use of day care and small size of housing units did not result in a high rate of carriage. The low rate of carriage may be linked to high use of antibiotics, geographical factors or ethnicity. High rates of antibiotic resistance reflect heavy use of antibiotics by general practitioners.

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Section: Discussioncontrasting

confidence: 52%

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Boost

O'Donoghue

Dooley³

2001

Epidemiol. Infect.

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“…The first community-acquired infection caused by multiply resistant pneumococci was documented in Denver, Colo., during 1981 (219). Strains were identified in Ohio (203) (241).…”

Section: Note On Nomenclature and Criteria Of Resistancementioning

confidence: 99%

Pneumococcal resistance to antibiotics

1990

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The geographic distribution of pneumococci resistant to one or more of the antibiotics penicillin, erythromycin, trimethoprim-sulfamethoxazole, and tetracycline appears to be expanding, and there exist foci of resistance to chloramphenicol and rifampin. Multiply resistant pneumococci are being encountered more commonly and are more often community acquired. Factors associated with infection caused by resistant pneumococci include young age, duration of hospitalization, infection with a pneumococcus of serogroup 6, 19, or 23 or serotype 14, and exposure to antibiotics to which the strain is resistant. At present, the most useful drugs for the management of resistant pneumococcal infections are cefotaxime, ceftriaxone, vancomycin, and rifampin. If the strains are susceptible, chloramphenicol may be useful as an alternative, less expensive agent. Appropriate interventions for the control of resistant pneumococcal outbreaks include investigation of the prevalence of resistant strains, isolation of patients, possible treatment of carriers, and reduction of usage of antibiotics to which the strain is resistant. The molecular mechanisms of penicillin resistance are related to the structure and function of penicillin-binding proteins, and the mechanisms of resistance to other agents involved in multiple resistance are being elucidated. Recognition is increasing of the standard screening procedure for penicillin resistance, using a 1-microgram oxacillin disk.

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“…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.…”

Section: Discussionmentioning

confidence: 52%

“…Our findings supports earlier studies from similar centers over the last decade. [9][10][11][12][13][14][15][16][17][18][19][20][21] Recent research established daycare attendance as an important factor influencing the epidemiology of many infectious diseases. [26][27][28] A number of studies have demonstrated a strong association between daycare attendance and increased carriage of S. pneumoniae, especially of resistant strains.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16][17][18][19][20][21] Upper respiratory tract and invasive infections caused by such strains have increased. Antibiotic-resistant pneumococci were more common in isolates from children in DCC than in isolates from patients admitted at a tertiary care hospital -a group of patients presumably at increased risk of infection by resistant strains.…”

Section: Introductionmentioning

confidence: 99%

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

Gómez-Barreto¹,

Calderón-Jaimes²,

Rodrı́guez³

et al. 2002

Salud pública Méx

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ResumenObjetivo. Analizar longitudinalmente la dinámica de colonización por Streptococcus pneumoniae, determinar la prevalencia, los factores de riesgo potencial para la colonización nasofaríngea con cepas de neumococo resistentes, determinar los serotipos y el perfil de sensibilidad a varios fár-macos antimicrobianos. Material y métodos. Estudio prospectivo de una cohorte de niños de guardería, hecho de septiembre de 1997 a septiembre de 1999 entre 53 niños asistentes a la guardería del Hospital Infantil de México Federico Gómez, atendida por 20 empleados. Todos los participantes fueron seguidos en forma prospectiva, tomándose exudado nasofaríngeo cada cuatro meses. Los S. pneumoniae aislados se tipificaron y sometieron a pruebas de sensibilidad a diversos fármacos. Las razones de momios y la prueba exacta de Fisher o ji cuadrada se efectuaron a través de tablas de contingencia; se utilizaron intervalos de confianza a 95% para las razones de momios. Para el análisis se empleó el programa estadístico EPI INFO, versión 6.04 a. Resultados. S. pneumoniae se recuperó de 45/53 niños en una o más de las tomas. Se aisló un total de 178 cepas. El promedio de portador fue de 47%. Sólo siete adultos adquirieron un neumococo durante el estudio. Los tipos 6, 14, 19 y 23 representaron 77% del total. Se encontró elevada resistencia a la penicilina y eritromicina. Conclusiones. El estado de portador nasofaríngeo de S. pneumoniae, es un proceso dinámico. La colonización ocurre durante los primeros meses de vida y comprende solamente unos cuantos serotipos de neumococo. El estado portador disminuye conforme avanza la edad. Se encontró alta proporción de portadores con cepas resistentes de neumococo. Los niños que recibieron varios cursos de antimicrobianos, fueron Patients were enrolled in the study during a two-year period from September 1997 to September 1999. All the participants were followed prospectively, swabbing them every four months. The strains recovered were typed and screened for susceptibility to several antibiotics. The daycare records were reviewed also. Odds ratios and fisher's exact test: or chi square test of significance were computed from contingency tables as appropriate. Exact 95% confidence intervals were computed for odds ratios. Data analysis was performed using Epi statistics program version 6.04 a.Results. Pneumococci were recovered from 45/53 of the infants at one or more visits. A total of 178 isolates were carried. The carriage rate was 47%. Only 7 adults acquired pneumococci during the study. Types 6,14,19 and 23 were prevalent and represented 77% of the total. Antibioticresistant strains were higher to penicillin and erythromycin. Conclusions. Children were frequent carriers of pneumococci, the rate of carriage was high in infancy and tended to decrease with age. The types commonly carried by children were the same as those causing invasive disease. There is a high proportion of carriers with antibiotic-resistant S. pneumoniae strains. Children who have had frequent antimicrobial courses are at p...

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Multiply Resistant Pneumococcus Causing Meningitis: Its Epidemiology Within a Day-Care Centre

Cited by 155 publications

References 19 publications

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Pneumococcal resistance to antibiotics

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

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