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Journal of Clinical Microbiology, September 2004, p. 3942-3949, Vol. 42, No. 9
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.9.3942-3949.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis Isolated from the Nasopharynges of Asymptomatic Children and Molecular Analysis of S. pneumoniae and H. influenzae Strain Replacement in the Nasopharynx

Agnieszka Sulikowska,^* Pawe Grzesiowski, Ewa Sadowy, Janusz Fiett, and Waleria Hryniewicz

National Institute of Public Health, Warsaw, Poland

Received 15 March 2004/ Returned for modification 30 April 2004/ Accepted 6 June 2004

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in 226 children in different settings (in a crèche [day care center], in an orphanage, and at home) during two seasons (winter and spring) was studied. The rates of carriage of S. pneumoniae and H. influenzae were markedly higher in the crèche and in the orphanage than in the home setting (e.g., 56.5, 63.3, and 25.9%, respectively, for S. pneumoniae in winter). Approximately 80% of the S. pneumoniae isolates identified in the crèche and in the orphanage belonged to the serotypes represented in the seven-valent pneumococcal vaccine, and 4.4% of the children were colonized by H. influenzae type b. Almost all H. influenzae isolates were fully susceptible to the antimicrobial agents tested, and only five (3.6%) produced ß-lactamase; in contrast, 100% of the M. catarrhalis isolates were ß-lactamase positive. Among S. pneumoniae isolates, 36.2% were nonsusceptible to penicillin (PNSP) and 11.8% were fully resistant to penicillin (PRP). All PNSP isolates were obtained from children at the crèche and at the orphanage but not among children brought up at home, and all PRP isolates showed a multiresistant phenotype. Colonization by PRP isolates correlated well with prior treatment with ß-lactams. For the majority of children colonized at both sampling times, strain replacement of S. pneumoniae and H. influenzae was observed; long-term colonization by a single strain was rare.

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