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The spread of multiply resistant Streptococcus pneumoniae at a day care center in Ohio

M R Reichler1, A A Allphin, R F Breiman

  • 1Respiratory Diseases Branch, Centers for Disease Control, Atlanta, Georgia 30333.

The Journal of Infectious Diseases
|December 1, 1992
PubMed

Insights

A penicillin-resistant Streptococcus pneumoniae strain spread widely in one daycare center, identified in 52 of 250 children. Frequent antibiotic use and prior infections were risk factors for carrying this resistant bacteria.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • Antibiotic resistance in Streptococcus pneumoniae is a growing global health concern.
  • Otitis media is a common childhood infection often treated with antibiotics.

Purpose of the Study:

  • To investigate the spread of a multidrug-resistant Streptococcus pneumoniae (type 23F) strain from a child with otitis media.
  • To identify risk factors associated with nasopharyngeal carriage of this resistant strain.

Main Methods:

  • Isolation of Streptococcus pneumoniae from middle ear fluid.
  • Nasopharyngeal culture surveys in children attending daycare centers.
  • Statistical analysis to determine risk factors for carriage.

Main Results:

  • A penicillin-resistant Streptococcus pneumoniae, type 23F, was isolated from a child with otitis media.
  • 52 out of 250 children at the index daycare center were identified as carriers.
  • No carriers were found in two other daycare centers.
  • Frequent antibiotic use and prophylactic antibiotic use were significant risk factors for carriage (P < .001).
  • Carriers had a higher likelihood of frequent otitis media episodes (P < .02) and treatment-unresponsive otitis media (P < .001).

Conclusions:

  • Judicious antibiotic use and reevaluation of prophylactic antibiotic strategies are crucial to limit the spread of resistant pneumococcal strains.
  • Daycare centers can be environments for the rapid dissemination of antibiotic-resistant bacteria.

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