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Nasopharyngeal carriage of resistant pneumococci in young South Indian infants

C L Coles1, L Rahmathullah, R Kanungo

  • 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Epidemiology and Infection
|February 1, 2003
PubMed

Insights

Antibiotic resistance in Streptococcus pneumoniae is a growing concern in South Indian infants. High rates of resistance to common antibiotics like cotrimoxazole and erythromycin were observed, necessitating better antibiotic stewardship.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Streptococcus pneumoniae causes severe infant infections globally.
  • Data on antibiotic resistance patterns in India are scarce.
  • Antibiotic resistance complicates the management of pneumococcal infections.

Purpose of the Study:

  • To investigate antibiotic resistance patterns of pneumococci in South Indian infants.
  • To determine the prevalence of antibiotic-resistant nasopharyngeal carriage.
  • To identify specific serotypes associated with resistance.

Main Methods:

  • Examined nasopharyngeal carriage in 464 South Indian infants (2-6 months).
  • Screened newly acquired serotypes for susceptibility to cotrimoxazole, erythromycin, and penicillin using disk diffusion.
  • Assessed prevalence of antibiotic resistance and multi-drug resistance.

Main Results:

  • Pneumococcal carriage prevalence increased from 53.9% to 70.2% between 2 and 6 months.
  • Resistance rates were 34% (penicillin), 81.1% (cotrimoxazole), and 37.2% (erythromycin).
  • Over 87% of isolates showed non-susceptibility to at least one antibiotic; less than 1% were multi-drug resistant.

Conclusions:

  • Widespread antibiotic use in South India has led to significant pneumococcal non-susceptibility.
  • Serogroups/types 6, 9, 14, 19, and 23 were frequently non-susceptible.
  • Monitoring resistance trends and prescription-only access may curb spread and improve infection management.

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