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Antibiotic-resistant pneumococci in hospitalized children
Insights
In South Africa, 31% of hospitalized children carried Streptococcus pneumoniae. Penicillin-resistant strains were linked to longer hospital stays and young age.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Public health
Background:
- Nasopharyngeal carriage of Streptococcus pneumoniae is a significant public health concern.
- Antibiotic resistance in S. pneumoniae poses a growing threat to effective treatment.
Purpose of the Study:
- To investigate the prevalence of nasopharyngeal carriers of Streptococcus pneumoniae in hospitalized children in Durban, South Africa.
- To identify factors associated with carriage of penicillin-resistant S. pneumoniae.
Main Methods:
- A cross-sectional study was conducted involving 573 hospitalized children.
- Nasopharyngeal cultures were obtained to identify S. pneumoniae and assess antibiotic susceptibility.
- Children were categorized into new admissions and those hospitalized for over 24 hours.
Main Results:
- Overall, 31% of children carried S. pneumoniae.
- Penicillin resistance was observed in 12% of isolates, with 11 strains resistant to multiple antibiotics.
- Penicillin-resistant strains belonged to serotypes 6 and 19.
- Factors associated with penicillin-resistant S. pneumoniae carriage included hospitalization >24 hours, young age, and recent beta-lactam antibiotic exposure.
Conclusions:
- Hospitalized children in Durban carry S. pneumoniae, with a notable proportion exhibiting penicillin resistance.
- Prolonged hospitalization, younger age, and recent antibiotic use are risk factors for carrying resistant strains.
- Understanding these factors is crucial for infection control strategies in pediatric settings.
Abstract:
A search for nasopharyngeal carriers of Streptococcus pneumoniae was conducted in 573 children hospitalized in Durban, South Africa. Study subjects were divided into two groups, comprising 305 new admissions and 268 patients who had been hospitalized for more than 24 h. Of the 573 children 178 (31%) yielded pneumococci on nasopharyngeal culture; 99 (32%) and 79 (29%) children in the new admission and in-patient categories respectively. Twenty-one (12%) pneumococci were resistant to penicillin, including 11 strains that were resistant to more than one antibiotic. Resistant pneumococci belonged exclusively to serotypes 6 and 19 (Danish nomenclature), which were also the commonest serotypes among penicillin-sensitive strains. Factors that correlated with carriage of penicillin-resistant pneumococci were hospitalization for more than 24 h, young age and recent exposure to beta-lactam antibiotics.