Nasopharyngeal colonization in southern Israel with antibiotic-resistant pneumococci during the first 2 years of life: relation to serotypes likely to be included in pneumococcal conjugate vaccines.
Nasopharyngeal carriage of Streptococcus pneumoniae was studied in 162 healthy infants at ages 2, 4, 6, 7, 12, and 13 months and in an additional 352 healthy children at ages 12, 15, 18, 21, and 24 months. Carriage was 26%, 39%, and 62% at 2, 12, and 24 months, respectively, and the respective resistance to > or = 1 antibiotic was 11%, 19%, and 27%. The presence of an older sibling or antibiotic treatment during the month preceding the culture was associated with carriage of resistant pneumococci in infants, whereas attendance at large day care centers was associated with carriage during the second year of life. Antibiotic resistance was detected in all 7 serotypes included in the candidate pediatric conjugate vaccines and was significantly more prevalent among vaccine-type pneumococci than among non-vaccine-type pneumococci. The use of conjugate vaccines may reduce the spread of resistant pneumococci.
Dagan
R
R
Pediatric Infectious Disease Unit and Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Melamed
R
R
Muallem
M
M
Piglansky
L
L
Yagupsky
P
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001428:Bacterial Vaccines / Q000032:analysis; D001431:Bacteriological Techniques; D002353:Carrier State / Q000453:epidemiology*; D002656:Child Day Care Centers; D002675:Child, Preschool; D002981:Clindamycin / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D009305:Nasopharynx / Q000382:microbiology*; D010406:Penicillins / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000254:growth & development*; D013752:Tetracycline / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014611:Vaccination
D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines; D010406:Penicillins; D002981:Clindamycin; D004917:Erythromycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D013752:Tetracycline