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Journal of Clinical Microbiology, March 1999, p. 798-800, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Antimicrobial Resistance and Serotype Distribution of Streptococcus pneumoniae Strains Causing Childhood Infections in Bangladesh, 1993 to 1997

Samir K. Saha,1,* N. Rikitomi,2 M. Ruhulamin,3 H. Masaki,2 M. Hanif,3 Maksuda Islam,1 K. Watanabe,2 K. Ahmed,2 K. Matsumoto,2 R. B. Sack,4,dagger and T. Nagatake1

Departments of Microbiology1 and Medicine,3 Dhaka Shishu (Children) Hospital, and Laboratory Sciences Division, International Centre for Diarrhoeal Disease and Research,4 Dhaka, Bangladesh, and Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan2

Received 20 July 1998/Returned for modification 1 October 1998/Accepted 13 November 1998

Three hundred sixty-two Streptococcus pneumoniae strains were isolated from children under 5 years of age at Dhaka Shishu (Children) Hospital from 1993 to 1997. The strains were isolated from blood (n = 105), CSF (n = 164), ear swab (n = 61), eye swab (n = 20), and pus (n = 12). Of the 362 isolates, 42 (11.6%) showed intermediate resistance (MIC, <0.1 µg/ml) and only 4 (1.1%) showed complete resistance (MIC, >2.0 µg/ml) to penicillin. Penicillin resistance exhibited a strong relationship with serotype 14; 47.8% of the penicillin-resistant strains belonged to this type. A remarkably high (64.1%) resistance to co-trimoxazole was observed, along with a significant increase during the time period studied; there was no relationship to capsular type. By way of contrast, penicillin resistance did not show any significant change during the study period. Resistance to chloramphenicol (2.2%) and erythromycin (1.1%) was rare. The high resistance to co-trimoxazole and its increasing trend demand elucidation of the clinical impact of pneumonia treatment by this antimicrobial and reconsideration of the World Health Organization recommendation for co-trimoxazole administration to children with community-acquired pneumonia at the health care worker level in Bangladesh.

* Corresponding author. Mailing address: Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu (Children) Hospital, Dhaka-1207, Bangladesh. Phone: 880 2 816061-2 or 880 2 814571-2. Fax: 880 2 861634. E-mail: sksaha{at}bangla.net.

dagger Present address: Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.

Journal of Clinical Microbiology, March 1999, p. 798-800, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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