title: Intermediate resistance of Streptococcus pneumoniae to penicillin in children in day-care centers.
abstract: This study was performed to determine the prevalence, serotypes and antibiotic susceptibility patterns of penicillin-resistant Streptococcus pneumoniae in children younger than 3 years of age in day-care centers in Houston, TX. Nasopharyngeal cultures were obtained on two occasions, in March and May, 1989, from 140 children in 4 day-care centers. All penicillin-resistant S. pneumoniae organisms isolated in this study had minimum inhibitory concentrations to penicillin of between 0.1 and 0.5 microgram/ml and were thus intermediately resistant. No highly resistant S. pneumoniae (minimum inhibitory concentration > or = 1.0 microgram/ml) was isolated in this study. Nasal carriage of S. pneumoniae occurred in 39% of children; carriage of intermediately resistant S. pneumoniae occurred in 4% of children. Of the 39% of children who carried S. pneumoniae, 11% carried intermediately resistant strains. In one day-care center with a prior history of intermediately resistant S. pneumoniae (Center 1), the prevalence of intermediate penicillin resistance was significantly (P = 0.047) higher than in the other three centers. Among children surveyed twice 15% of Center 1 children carried an intermediately penicillin-resistant strain at least once, whereas in the other centers 3% of children carried an intermediately resistant strain at least once. Sixty-two percent of intermediately penicillin-resistant strains were resistant to multiple antibiotics and all were serotype 14. Intermediately penicillin-resistant S. pneumoniae isolates were prevalent among young children in day-care centers in Houston and may persist in some day-care centers and become endemic.
authors.affiliation: Department of Pediatrics, University of Texas Medical School, Houston.
authors.forename: M G
authors.initials: MG
authors.lastname: Doyle
authors.forename: A L
authors.initials: AL
authors.lastname: Morrow
authors.forename: R
authors.initials: R
authors.lastname: Van
authors.forename: L K
authors.initials: LK
authors.lastname: Pickering
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000382:microbiology*; D012703:Serotyping; D013045:Species Specificity; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects*