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Antibiotic resistance in Streptococcus pneumoniae isolated from children
D Nasrin1, P J Collignon, E J Wilson
1National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia. dilruba.nasrin@anu.edu.au
Insights
Antibiotic resistance in Streptococcus pneumoniae (S. pneumoniae) is a concern in healthy children. Daycare attendance and prior antibiotic use significantly increase the risk of carrying resistant S. pneumoniae strains.
Area of Science:
- Microbiology
- Public Health
- Pediatrics
Background:
- Antibiotic resistance in Streptococcus pneumoniae (S. pneumoniae) poses a growing public health threat.
- Understanding resistance patterns in pediatric populations is crucial for effective treatment strategies.
Purpose of the Study:
- To determine the prevalence of antibiotic resistance in S. pneumoniae isolates from healthy children.
- To investigate factors associated with antibiotic-resistant S. pneumoniae carriage in young children.
Main Methods:
- A cross-sectional community survey was conducted involving 461 children under 3 years old.
- Nasal swabs were collected and analyzed for S. pneumoniae and antibiotic resistance profiles.
- Statistical analysis identified associations between daycare attendance, antibiotic use, and resistant S. pneumoniae carriage.
Main Results:
- S. pneumoniae was isolated from 37.1% of children.
- Penicillin resistance was observed in 12.3% of isolates, with higher rates for co-trimoxazole (44.4%) and erythromycin (18.1%).
- Multidrug resistance was found in 19% of isolates. Daycare attendance and prior antibiotic use were significantly associated with carrying resistant strains.
Conclusions:
- The level of antibiotic resistance in S. pneumoniae from healthy children is concerning.
- Daycare attendance and antibiotic use are significant risk factors for carrying antibiotic-resistant S. pneumoniae.
- Judicious antibiotic use in children is recommended to mitigate the spread of resistance.
Objective:
To determine the level of antibiotic resistance in pneumoniae (S. pneumoniae) isolated from nasal swabs of healthy children.
Method:
Cross-sectional community survey.
Setting:
Survey was undertaken in general practice settings in Canberra during March and April 1998.
Subjects:
Four hundred and sixty-one children under 3 years of age enrolled in general practice trial of clinical practice guidelines for antibiotic use.
Outcome Measures:
Resistance to penicillin, erythromycin, co-trimoxazole, tetracycline, chloramphenicol and cefotaxime among the isolates of S. pneumoniae.
Results:
A total of 461 nasal swabs were collected and S. pneumoniae was isolated from 171 (37.1%). Penicillin resistance was found in 12.3% of these isolates, with high level resistance in 0.6%. Resistance rates were higher for cotrimoxazole (44.4%) and erythromycin (18.1%) than for penicillin. Multidrug resistance was found in 19% of these isolates. There was a significant association between the attendance at a day care centre and carriage of pneumococcus (53% vs 32%, odds ratio (OR) 2.4, 95% confidence interval (CI) 1.5-3.7, P < 0.001). Children who attended day care centers and had received antibiotics during the 4 months prior to swab collection were three times more likely to carry an antibiotic-resistant isolate than children who had neither attended a day care centre nor received antibiotics (68% vs 40%, OR 3.1, 95% CI 1.2-8.4, P = 0.02).
Conclusion:
The level of antibiotic resistance in pneumococci from healthy children was of concern. Carriage of pneumococcus was significantly higher in children who attended a day care centre. Resistance was significantly correlated with antibiotic use in combination with day-care attendance. These findings warrant more judicious use of antibiotics in children.