ABSTRACT
OBJECTIVES: To evaluate the clinical and laboratory findings of Streptococcus pneumoniae acute otitis media in children during a 1 year period. METHODS: From October 1995 to September 1996, 113 children aged 2 months to 14 years (median 18 months), with S. pneumoniae acute otitis media were studied. Susceptibility testing was performed by the Kirby-Bauer method and the E-test, and serotyping by the Quellung reaction. RESULTS: E-test assays detected five isolates (4.4%) to be highly resistant to penicillin and 13 (11.5%) that had intermediate resistance. All isolates were found to be susceptible to vancomycin, rifampicin and cefotaxime. In total, 25 isolates (22.1%) were resistant to one or more drugs. Fifty per cent of the penicillin-resistant or intermediately resistant S. pneumoniae isolates were resistant to multiple drugs, whereas only 2.1% of the penicillin-susceptible isolates were resistant to multiple drugs. The predominating serogroups of the isolates with reduced susceptibility to penicillin were the 19 (61.1%), 9 (16.7%), 23 (11.1%), 6 (5.5%) and 14 (5.5%) whereas those of the susceptible isolates were the 19 (26.3%), 14 (13.7%), 3 (11.6%), 6 (11.6%), 9 (8.4%), 1 (5.3%) and 12 (5.3%). CONCLUSIONS: Streptococcus pneumoniae isolates from children with acute otitis media were penicillin-insensitive in 15.9%. The multiresistant S. pneumoniae isolates belonged to serogroups: 19 (45.4%), 9 (27.3%), 6 (18.2%) and 23 (9.1%).
Subject(s)
Disease Susceptibility , Drug Resistance, Microbial , Otitis Media/microbiology , Streptococcal Infections/microbiology , Streptococcus pneumoniae/isolation & purification , Acute Disease , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Drug Resistance, Multiple , Ear, Middle/microbiology , Ear, Middle/pathology , Female , Humans , Infant , Infant, Newborn , Male , Microbial Sensitivity Tests , Otitis Media/diagnosis , Otitis Media/drug therapy , Serotyping , Streptococcal Infections/drug therapy , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/pathogenicitySubject(s)
Immunocompromised Host , Lung Diseases/etiology , Nocardia Infections/etiology , Nocardia asteroides , Respiratory Tract Infections/etiology , Anemia, Hemolytic, Autoimmune/drug therapy , Child , Fatal Outcome , Female , Greece , Humans , Immunosuppressive Agents/therapeutic use , Syndrome , Thrombocytopenia/drug therapySubject(s)
Anti-Bacterial Agents/pharmacology , Erythromycin/pharmacology , Streptococcus/classification , Streptococcus/drug effects , Child , Child, Preschool , Clarithromycin/pharmacology , Clindamycin/pharmacology , Drug Resistance, Microbial , Greece , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests , PhenotypeSubject(s)
Bacteremia/etiology , Catheters, Indwelling/adverse effects , Child, Hospitalized/statistics & numerical data , Cross Infection/etiology , Causality , Child , Child, Preschool , Greece , Hospitals, Pediatric , Humans , Incidence , Infant , Infant, Newborn , Infection Control , Retrospective StudiesABSTRACT
The prevalence and patterns of Streptococcus pneumoniae resistance to antibiotics was examined in 146 nasopharyngeal carrier strains obtained during April and May, 1997, from 382 healthy children attending eight day care centers (DCCs) in the area of Athens. Reduced susceptibility to at least one antibiotic was found in 32.6% as follows: penicillin 11.4% (intermediate), cefotaxime 0.8% (intermediate), trimethoprim-sulfamethoxazole 22.7%, erythromycin 13.6%, tetracycline 11.4%, chloramphenicol 8.3%. Most of the nonsusceptible to penicillin isolates belonged to serogroups 23, 9, and 19. Multidrug resistance was detected in 11.4% of S. pneumoniae isolates including five penicillin nonsusceptible serogroup 23 strains. More than half of the multidrug resistant strains were susceptible to penicillin and belonged to serogroups 6 (4), 23 (1), 19 (1), and 1(1). Strains that belonged to the same serogroup/serotype and had identical resistance patterns appeared to cluster in some DCCs. Antibiotic use in the previous month was associated with reduced susceptibility to penicillin (p = 0.007) and multidrug resistance (p = 0.012). In conclusion, a moderate prevalence of reduced susceptibility to penicillin in pneumococcal carrier strains was found in our community. Multidrug resistance was common and was often associated with susceptibility to penicillin. Several distinct patterns of resistance were observed, suggesting the spread of resistant clones to our country.
