Carriage of Antibiotic-Resistant Pneumococci among Asian Children: A Multinational Surveillance by the Asian Network for Surveillance of Resistant Pathogens (ANSORP)

Abstract

To investigate the nasal carriage of antibiotic-resistant pneumococci by children, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be nonsusceptible to penicillin. Prevalence of penicillin nonsusceptibility was highest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban areas, enrollment in day care, and a history of otitis media. The most common serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common clone, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resistance among isolates of pneumococci carried nasally in children in Asia and the Middle East and showed that this is due to the spread of a few predominant clones in the region.

Increasing invasive disease due to penicillin resistant <i> S. pneumoniae </i> in India

“…[11] This latest recommendation for the Þ rst time is based on the clinical syndrome and route of penicillin administration. Further, this MIC break point tends to change the earlier Þ ndings of PIRSP, published in the literature up to early 2008, to a much lower percentage for non meningitis isolates [1][2][3]5,[8][9][10] and higher percentage of complete penicillin resistance to meningitis isolates. [6,7] However, this particular study isolate antimicrobial MIC break point interpretation remains valid as it conforms to CLSI 2008 recommendation also.…”

“…A well-known and widespread study conducted in Asia by ANSORP [1][2][3] (Asian Network for Surveillance of Resistant Pathogens) reported the highest prevalence of penicillin resistance in isolates from Vietnam (71.4%), followed …”

“…Thereafter the proportion of PIRSP has been steadily increasing over the last decade. This includes 3.8% in 1996-97 among the clinical isolates [1] 12.8% among carriage isolates; [2] 7.8% in 2000 -2001 among the clinical pathogens [3] ; and 1.48% in 1993-97 among clinical isolates. [5] Nevertheless, in 1999, [6] a 4.6% (n = 25) which included eight CSF isolates with intermediate resistant to penicillin (0.125-1.0 µg/ml) was reported.…”

“…Notably, among the Asian countries, India had the lowest percentage of penicillin intermediate resistance to S. pneumoniae (PIRSP) and virtually no complete penicillin resistance in IPD isolates. [1][2][3] Here,…”

Emergence in Vietnam of Streptococcus pneumoniae Resistant to Multiple Antimicrobial Agents as a Result of Dissemination of the Multiresistant Spain 23F -1 Clone

“…However, pneumococci resistant to multiple antimicrobial agents including penicillin have become significantly more common in the last 15 years and have become a worldwide problem (33). Countries in the Far East have some of the highest levels of resistance to penicillin and other commonly used antimicrobials (17,30). There are limited data concerning this issue from Vietnam.…”