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Journal of Clinical Microbiology, July 1998, p. 1933-1937, Vol. 36, No. 7
Department of Pediatrics and Section of
Microbiology,
Received 27 October 1997/Returned for modification 23 December
1997/Accepted 30 March 1998
Resistance (intermediate and high) to penicillin among
Streptococcus pneumoniae strains is an emerging problem
worldwide. From 1995 to 1997, isolates of S. pneumoniae not
susceptible to penicillin were seen with increasing frequency from
blood, cerebrospinal fluid, pleural fluid, and middle ear fluid from
pediatric patients at the Veterans General Hospital-Kaohsiung. To
determine the prevalence of carriage of these penicillin-nonsusceptible
S. pneumoniae isolates, we obtained nasopharyngeal swab
specimens from 2,905 children (ages, 2 months to 7 years) attending
day-care centers or kindergartens or seen in our outpatient clinic.
S. pneumoniae was isolated from 611 children, and 584 strains were available for analysis. The oxacillin disc test was used
as a screening test to evaluate penicillin susceptibility. The MICs of
11 antibiotics (penicillin, cefaclor, cefuroxime, ceftriaxone,
cefotaxime, imipenem, chloramphenicol, clarithromycin, rifampin,
vancomycin, and teicoplanin) were determined by the E-test. Only 169 (29%) of the strains were susceptible to penicillin; 175 (30%)
strains were intermediately resistant and 240 (41%) were highly
resistant. The isolates also demonstrated high rates of resistance to
other
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Extremely High Prevalence of Nasopharyngeal
Carriage of Penicillin-Resistant Streptococcus pneumoniae
among Children in Kaohsiung, Taiwan
-lactams (46% were resistant to cefaclor, 45% were resistant
to cefuroxime, 45% were resistant to ceftriaxone, 31% were resistant
to cefotaxime, and 46% were resistant to imipenem). The rate of
resistance to macrolide antimicrobial agents was strikingly high; 95%
of the isolates were not susceptible to clarithromycin. However, 97%
were susceptible to rifampin and 100% were susceptible to the two
glycopeptides (vancomycin and teicoplanin). While reports of
penicillin-resistant S. pneumoniae increased worldwide
through the 1980s, the high prevalence (71%) of resistance reported
here is astonishing. Surveillance of nasopharyngeal swab specimen
cultures may provide useful information on the prevalence of
nonsusceptible strains causing invasive disease. Such information could
be used to guide therapy of pneumococcal infections.
*
Corresponding author. Mailing address: Section of
Infectious Diseases, Veterans General Hospital-Kaohsiung, 386 Ta-Chung
1st Rd, Kaohsiung, Taiwan, Republic of China. Phone: (07)3468098. Fax:
(07)3416137. E-mail: ccchiou{at}isca.vghks.gov.tw.
Journal of Clinical Microbiology, July 1998, p. 1933-1937, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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