Premium
Antibiotic resistance in Streptococcus pneumoniae isolated from children
Author(s) -
Nasrin D,
Collig PJ,
Wilson EJ,
Pilotto LS,
Douglas RM
Publication year - 1999
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.1999.00416.x
Subject(s) - medicine , streptococcus pneumoniae , erythromycin , penicillin , cefotaxime , antibiotics , antibiotic resistance , carriage , odds ratio , pediatrics , microbiology and biotechnology , biology , pathology
Objective: To determine the level of antibiotic resistance in pneumoniae ( S. pneumoniae ) isolated from nasal swabs of healthy children. Method: Cross‐sectional community survey. Setting: Survey was undertaken in general practice settings in Canberra during March and April 1998. Subjects: Four hundred and sixty‐one children under 3 years of age enrolled in a general practice trial of clinical practice guidelines for antibiotic use. Outcome measures: Resistance to penicillin, erythromycin, co‐trimoxazole, tetracycline, chloramphenicol and cefotaxime among the isolates of S. pneumoniae . Results: A total of 461 nasal swabs were collected and S. pneumoniae was isolated from 171 (37.1%). Penicillin resistance was found in 12.3% of these isolates, with high level resistance in 0.6%. Resistance rates were higher for cotrimoxazole (44.4%) and erythromycin (18.1%) than for penicillin. Multidrug resistance was found in 19% of these isolates. There was a significant association between the attendance at a day care centre and carriage of pneumococcus (53% vs 32%, odds ratio (OR) 2.4, 95% confidence interval (CI)1.5–3.7, P < 0.001). Children who attended day care centres and had received antibiotics during the 4 months prior to swab collection were three times more likely to carry an antibiotic‐resistant isolate than children who had neither attended a day care centre nor received antibiotics (68% vs 40%, OR 3.1, 95% CI 1.2–8.4, P = 0.02). Conclusion: The level of antibiotic resistance in pneumococci from healthy children was of concern. Carriage of pneumococcus was significantly higher in children who attended a day care centre. Resistance was significantly correlated with antibiotic use in combination with day‐care attendance. These findings warrant more judicious use of antibiotics in children.