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Capsular serotypes and antibiotic sensitivity of Streptococcus pneumoniae isolated from primary-school children
E J Ridgway1, C H Tremlett, K D Allen
1Department of Microbiology, Whiston Hospital, Prescot, Merseyside, U.K.
Insights
A significant portion of primary school children carry Streptococcus pneumoniae. Penicillin-resistant strains were common, particularly in serogroup 23, and linked to hospital admissions.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Public Health
Background:
- Streptococcus pneumoniae (pneumococcus) is a leading cause of bacterial infections in children.
- Antibiotic resistance in pneumococcal strains is a growing global health concern.
- Understanding carriage rates and resistance patterns in primary school settings is crucial for public health strategies.
Purpose of the Study:
- To determine the prevalence of pneumococcal carriage in primary school children.
- To characterize the antibiotic resistance profiles of carried pneumococcal isolates.
- To identify risk factors associated with pneumococcal carriage, particularly penicillin-resistant strains.
Main Methods:
- Screening of 1049 primary school children across 18 schools for Streptococcus pneumoniae carriage.
- Collection of data on family size, antibiotic use, travel history, and hospital admissions.
- Pneumococcal serotyping and antibiotic sensitivity testing of collected isolates.
Main Results:
- One-third of children were identified as pneumococcal carriers.
- Penicillin resistance was observed in 2.9% of isolates; however, co-resistance to other antibiotics was common in these strains.
- Serogroup 23 strains showed a significantly higher likelihood of penicillin resistance, and hospital admission was associated with carrying penicillin-resistant strains.
Conclusions:
- Pneumococcal carriage is common in primary school children, with notable levels of penicillin resistance.
- Serogroup 23 is a key serotype associated with penicillin resistance.
- Hospital admission is a significant risk factor for carrying penicillin-resistant pneumococci, highlighting the need for community surveillance.
Abstract:
A total of 1049 primary-school children in 18 schools were screened for carriage of Streptococcus pneumoniae. Data on family size, antibiotic use, travel and hospital admissions were collected. Pneumococcal serotyping and sensitivity tests were performed. One third of children were found to be pneumococcal carriers. Ten of 344 isolates were penicillin-resistant (2.9%). Apart from resistance to trimethoprim and ciprofloxacin, resistance rates in penicillin-sensitive strains were low. Among penicillin-resistant strains (PRP), co-resistance to trimethoprim, chloramphenicol and tetracycline was common. Cefotaxime-resistance was seen in 90% of PRP. Although 24 serotypes were represented, groups 6, 19 and 23 accounted for 55% of strains. Serogroup 23 strains were significantly more likely to be penicillin-resistant than other groups/types. Clustering of strains by serotype and antibiotic resistance was seen in several schools. No association with foreign travel, family size or age of siblings was seen and penicillin resistance was not associated with prior antibiotic use. However, hospital admission was significantly associated with carriage of PRP. The implications of detecting PRP in the community are discussed.