title: High prevalence of multidrug-resistant Streptococcus pneumoniae among children in a rural Kentucky community.
abstract: In 1992 drug-resistant Streptococcus pneumoniae was cultured with increasing frequency from aspirates of middle ear fluid from children with acute otitis media in a rural Kentucky community. To determine the prevalence of carriage of drug-resistant S. pneumoniae in the community, we obtained nasopharyngeal swabs from 158 (70%) of 227 children attending a child daycare center and from 82 children attending the county health center. S. pneumoniae was isolated from 126 children. Among 123 isolates tested 65 (53%) were penicillin-resistant, including 41 (33%) strains that were highly resistant; 61 (50%) were multidrug-resistant. Serotypes 19F, 6B, 23F and 6A comprised 89% of the penicillin-resistant isolates. Detection of a variety of serotypes and drug resistance patterns among nasopharyngeal isolates of S. pneumoniae suggests that multidrug-resistant pneumococcal strains are endemic in this community. Surveillance for drug-resistant pneumococci with the use of respiratory secretions obtained by nasopharyngeal swab may provide useful information on the prevalence of drug-resistant strains causing invasive disease and otitis media. Such information could be used to guide empiric therapy of pneumococcal infections.
authors.affiliation: Childhood and Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Duchin
authors.forename: R F
authors.initials: RF
authors.lastname: Breiman
authors.forename: A
authors.initials: A
authors.lastname: Diamond
authors.forename: H B
authors.initials: HB
authors.lastname: Lipman
authors.forename: S L
authors.initials: SL
authors.lastname: Block
authors.forename: J A
authors.initials: JA
authors.lastname: Hedrick
authors.forename: R
authors.initials: R
authors.lastname: Finger
authors.forename: J A
authors.initials: JA
authors.lastname: Elliott
mesh_terms: D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006801:Humans; D007223:Infant; D007629:Kentucky / Q000453:epidemiology; D016015:Logistic Models; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology; D010034:Otitis Media with Effusion / Q000188:drug therapy / Q000382:microbiology; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification