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Antibiotic resistance among respiratory pathogens in preschool children
1Dorevitch Pathology, Melbourne, VIC.
Insights
Antibiotic resistance in common respiratory germs found in young children is significant and may be rising. This underscores the impact of community antibiotic use and the misuse of antibiotics for viral infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance poses a growing threat to public health.
- Respiratory pathogens in young children are a key reservoir for antibiotic resistance genes.
Purpose of the Study:
- To determine the prevalence of antibiotic resistance in common respiratory pathogens among preschool children.
- To investigate trends in antibiotic resistance over a three-year period.
Main Methods:
- A survey of nasal discharge swabs from children aged six years and under in childcare settings in Melbourne and Sydney.
- Testing for resistance to penicillins, erythromycin, and tetracycline in isolates of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus.
Main Results:
- High rates of resistance were observed: 93.6% of M. catarrhalis and 91.2% of S. aureus were resistant to penicillin.
- Penicillin resistance showed an increasing trend in H. influenzae and S. pneumoniae isolates over the study period.
- Beta-lactamase production was detected in 23.3% of H. influenzae type b strains.
Conclusions:
- Significant and potentially increasing antibiotic resistance among preschool children's respiratory pathogens.
- Highlights the impact of community antibiotic prescribing practices.
- Suggests a need for judicious antibiotic use, especially for viral infections.
Objective:
To determine the prevalence of antibiotic resistance among common respiratory pathogens circulating in the community.
Design:
Survey of common respiratory pathogens isolated from nasal discharges.
Setting:
117 childcare centres and kindergartens in metropolitan Melbourne between May and July 1991-1993 and 42 from sociodemographically matching suburbs in Sydney between May and July, 1993.
Subjects:
Children aged six years and under with nasal discharge.
Outcome Measures:
Resistance to penicillins, erythromycin and tetracycline among isolates of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella (Branhamella) catarrhalis and Staphylococcus aureus.
Results:
A total of 2286 nasal discharge swabs were collected. Amoxycillin resistance was detected in 99 of 711 isolates of H. influenzae (13.9%) and penicillin resistance in 781 of 834 isolates of M. catarrhalis (93.6%), 342 of 375 isolates of S. aureus (91.2%), and 30 of 781 isolates of S. pneumoniae (3.9%). Of 86 strains of H. influenzae type b isolated, 20 (23.3%) produced beta-lactamase. Penicillin resistance tended to become more common among isolates of H. influenzae and S. pneumoniae during the three-year period.
Conclusion:
Antibiotic resistance, mediated by beta-lactamase or altered penicillin-binding proteins, among respiratory pathogens carried by preschool children was significant and possibly increasing. This highlights the impact of prescribed antibiotics in the community and the folly of prescribing the limited store of antibiotics for viral infections.