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Colonization with penicillin-resistant Streptococcus pneumoniae in a child-care center
D J Boken1, S A Chartrand, R V Goering
1Department of Pediatrics, Creighton University, Omaha, NE 68178, USA.
The Pediatric Infectious Disease Journal
|October 1, 1995
Summary
Penicillin-resistant Streptococcus pneumoniae strains were common in child-care centers. Horizontal transmission of resistant strains occurred, suggesting child-care settings are linked to resistant pneumococcal colonization.
Area of Science:
- Pediatrics
- Microbiology
- Epidemiology
Background:
- Streptococcus pneumoniae colonization is common in young children.
- Penicillin resistance in S. pneumoniae is a growing public health concern.
- Child-care centers (CCCs) are environments where respiratory pathogens can spread easily.
Purpose of the Study:
- To investigate the prevalence and genetic diversity of penicillin-resistant S. pneumoniae in a child-care center.
- To assess the transmission dynamics of S. pneumoniae within a CCC.
- To explore the impact of antibiotic selective pressure on resistant pneumococcal colonization.
Main Methods:
- Nasopharyngeal cultures were collected from children aged 2-24 months in an Omaha CCC.
- Pulsed field gel electrophoresis (PFGE) was used for DNA subtyping of S. pneumoniae isolates.
- Isolates were tested for penicillin resistance using minimal inhibitory concentration (MIC) breakpoints.
Main Results:
- 59% of children were colonized with S. pneumoniae.
- 53% of pneumococcal isolates were highly resistant to penicillin (HR-SP), and 22% were intermediately resistant (IR-SP).
- PFGE revealed distinct subtypes within serotypes, with a predominant strain suggesting horizontal transmission.
- Colonization rates remained similar after 4 months, but the proportion of resistant isolates decreased significantly (7% HR-SP, 39% IR-SP).
- Antibiotic use decreased between sampling periods, correlating with reduced resistant S. pneumoniae.
Conclusions:
- Multiple genetic clones of penicillin-resistant S. pneumoniae can coexist in CCCs.
- Individual clones of penicillin-resistant S. pneumoniae can spread among children in CCCs.
- Colonization with penicillin-resistant S. pneumoniae should be considered a CCC-associated phenomenon, particularly during periods of high antibiotic selective pressure.