Nasopharyngeal Carriage of Antibiotic-Resistant Pneumococci by Children in Group Day Care

Abstract

We compared rates of antibiotic resistance in strains of Streptococcus pneumoniae recovered from nasopharyngeal secretions of a group of children studied longitudinally in a research day care center between 1978 and 1985 and recovered from usually sterile body fluids of patients at a tertiary care hospital between 1981 and 1985. The prevalence of trimethoprim-sulfamethoxazole (TMP-SMZ) resistance was 11.5% in isolates from the hospital, whereas 30.0% of episodes of nasopharyngeal carriage of S. pneumoniae studied in day care children included TMP-SMZ-resistant isolates. The proportion of episodes of colonization with TMP-SMZ-resistant isolates in the day care study increased from 5.4% before 1981 to 39% between 1981 and 1985. Isolates of S. pneumoniae relatively resistant (MIC greater than or equal to 0.125 micrograms/mL) to penicillin G, amoxicillin, or cefuroxime accounted for 8% of isolates from the hospital and 11.9% of episodes of nasopharyngeal colonization in children in day care. Pneumococci with reduced susceptibility to either TMP-SMZ or a beta-lactam antibiotic were recovered from 68% of 72 children in the day care study.

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

“…[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. 13,28,29 Study findings demonstrated that daycare attendance and patterns of antibiotic use may be important factors influencing the epidemiology of antibiotic-resistant bacteria.…”

“…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.…”

“…[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.…”

“…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. 12,13,20 This paper presents the results of the Institutional Surveillance System for Pneumococcal Infections during 1997-1999. The objectives of the present study were to determine the prevalence and potential risk factors for nasopharyngeal colonization with antibiotic-resistant pneumococci, and to describe its serotypes and its antibiotic susceptibility patterns.…”

Outbreak of Pneumococcal Pneumonia among Military Recruits

“…It is a disease of continuing endemicity particularly in infancy and old age [6]. Day care centres are very likely to be places for spread of organisms in toddlers [7,8,9,10]. In military medical literature, there are accounts of pneumococcal outbreaks.…”