title: Nasopharyngeal carriage of antibiotic-resistant pneumococci by children in group day care.
abstract: We compared rates of antibiotic resistance in strains of Streptococcus pneumoniae recovered from nasopharyngeal secretions of a group of children studied longitudinally in a research day care center between 1978 and 1985 and recovered from usually sterile body fluids of patients at a tertiary care hospital between 1981 and 1985. The prevalence of trimethoprim-sulfamethoxazole (TMP-SMZ) resistance was 11.5% in isolates from the hospital, whereas 30.0% of episodes of nasopharyngeal carriage of S. pneumoniae studied in day care children included TMP-SMZ-resistant isolates. The proportion of episodes of colonization with TMP-SMZ-resistant isolates in the day care study increased from 5.4% before 1981 to 39% between 1981 and 1985. Isolates of S. pneumoniae relatively resistant (MIC greater than or equal to 0.125 micrograms/mL) to penicillin G, amoxicillin, or cefuroxime accounted for 8% of isolates from the hospital and 11.9% of episodes of nasopharyngeal colonization in children in day care. Pneumococci with reduced susceptibility to either TMP-SMZ or a beta-lactam antibiotic were recovered from 68% of 72 children in the day care study.
authors.affiliation: Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27514.
authors.forename: F W
authors.initials: FW
authors.lastname: Henderson
authors.forename: P H
authors.initials: PH
authors.lastname: Gilligan
authors.forename: K
authors.initials: K
authors.lastname: Wait
authors.forename: D A
authors.initials: DA
authors.lastname: Goff
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology; D002353:Carrier State / Q000382:microbiology*; D002444:Cefuroxime / Q000494:pharmacology; D002656:Child Day Care Centers; D002675:Child, Preschool; D004338:Drug Combinations / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D009305:Nasopharynx / Q000382:microbiology*; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D013420:Sulfamethoxazole / Q000494:pharmacology; D014295:Trimethoprim / Q000494:pharmacology; D014296:Trimethoprim Resistance; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
chemical_list: D004338:Drug Combinations; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D002444:Cefuroxime