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Patterns of antibiotic-resistant Streptococcus pneumoniae in children in a day-care setting
A G Mainous1, M E Evans, W J Hueston
1Department of Family Practice, University of Kentucky, Lexington 40536-0284, USA.
Insights
Antibiotic-resistant Streptococcus pneumoniae is a growing concern in young children. This study found high rates of resistance to common antibiotics like penicillin in children attending day-care centers.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance surveillance
- Public health microbiology
Background:
- Streptococcus pneumoniae causes significant childhood illness and mortality.
- Increasing prevalence of antibiotic-resistant strains poses a major public health threat.
- Day-care settings are potential hubs for pathogen transmission among young children.
Purpose of the Study:
- To determine the prevalence of antibiotic-resistant Streptococcus pneumoniae in children attending day-care facilities.
- To assess resistance patterns to key antibiotics in a mixed rural and urban population.
- To inform strategies for managing childhood respiratory tract infections.
Main Methods:
- Nasopharyngeal cultures collected from 104 children in eight central Kentucky day-care centers (rural and urban).
- Isolates of Streptococcus pneumoniae were identified and tested for susceptibility to penicillin, trimethoprim-sulfamethoxazole, erythromycin, tetracycline, vancomycin, and cefotaxime.
- Data analyzed for resistance prevalence, multiple drug resistance, and correlations with age and location.
Main Results:
- 54% of S. pneumoniae isolates were resistant to penicillin; 40% were resistant to trimethoprim-sulfamethoxazole.
- 60% of isolates showed resistance to at least one tested antimicrobial; 43% were resistant to multiple antimicrobials.
- Children with penicillin-resistant isolates were significantly younger (mean age 2.7 years) than those with susceptible isolates (mean age 3.7 years).
Conclusions:
- A substantial proportion of Streptococcus pneumoniae isolates in young children exhibit antibiotic resistance.
- The findings highlight the need to re-evaluate outpatient treatment strategies for pediatric respiratory infections.
- Effective control of S. pneumoniae drug resistance may require updated therapeutic guidelines.
Background:
Streptococcus pneumoniae is one of the primary causes of illness and death among young children, and evidence suggests that the prevalence of antibiotic-resistant S pneumoniae is increasing. The purpose of this study was to investigate the prevalence of antibiotic-resistant S pneumoniae in a sample of children in day-care facilities in a region that includes both rural and urban communities.
Methods:
Nasopharyngeal cultures were obtained from 104 children in eight day-care centers located in rural and urban central Kentucky in April and May, 1997. Thirty-five of the children produced isolates positive for S pneumoniae. Each isolate was tested for susceptibility to penicillin, trimethoprim-sulfamethoxazole, erythromycin, tetracycline, vancomycin, and cefotaxime.
Results:
Of the children with S pneumoniae isolates, 54% had isolates that were resistant to penicillin and 40% that were resistant to trimethoprim-sulfamethoxazole. Twenty-one (60%) of the isolates had resistance to at least one of the six tested antimicrobials, with 15 (43%) having resistance to more than one of the antimicrobials. The mean age of children with isolates resistant to penicillin was significantly less (2.7 + 1.6) than those with penicillin-susceptible isolates (3.7 + 1.1, P = .02). There was no relation between resistance and rural or urban day-care location.
Conclusions:
A substantial proportion of S pneumoniae isolates in young children are resistant to antibiotics. Limiting the effect of S pneumoniae drug resistance may require a reexamination of outpatient treatment strategies for childhood respiratory tract infections.