title: Multiple antimicrobial resistance of pneumococci in children with otitis media, bacteremia, and meningitis in Slovakia.
abstract: Penicillin-resistant pneumococci have been isolated from middle ear fluid, blood, cerebrospinal fluid, and nasopharyngeal secretions of several hundred children in Slovakia since 1985; 116 of these isolates were serotyped and tested for susceptibility to antimicrobial drugs at the Centers for Disease Control and Prevention. To define the prevalence of drug-resistant pneumococci and identify risk factors for infection, laboratory and medical records were reviewed. Nearly all (96%) of the resistant strains tested were serotype 14. Of these, all were resistant to penicillin (MIC, 4-16 micrograms/mL); most were resistant to cefaclor, erythromycin, tetracycline, and chloramphenicol; and many had decreased susceptibility to trimethoprim-sulfamethoxazole and ceftriaxone. Frequent antibiotic use, prior hospitalization, and length of hospital stay (P < .001 for all 3) were associated with infection with resistant strains. These findings suggest the need for routine screening of pneumococcal isolates for penicillin resistance and highlight the importance of controlling globally the spread of resistant pneumococci.
authors.affiliation: Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Reichler
authors.forename: J
authors.initials: J
authors.lastname: Rakovsky
authors.forename: A
authors.initials: A
authors.lastname: Sobotová
authors.forename: M
authors.initials: M
authors.lastname: Sláciková
authors.forename: B
authors.initials: B
authors.lastname: Hlavácová
authors.forename: B
authors.initials: B
authors.lastname: Hill
authors.forename: L
authors.initials: L
authors.lastname: Krajcíková
authors.forename: P
authors.initials: P
authors.lastname: Tarina
authors.forename: R R
authors.initials: RR
authors.lastname: Facklam
authors.forename: R F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D016470:Bacteremia / Q000382:microbiology*; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D006801:Humans; D008581:Meningitis / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D010033:Otitis Media / Q000382:microbiology*; D012307:Risk Factors; D012703:Serotyping; D018154:Slovakia; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000635:transmission; D013296:Streptococcus pneumoniae / Q000187:drug effects*