title: Colonization by Streptococcus pneumoniae among human immunodeficiency virus-infected adults: prevalence of antibiotic resistance, impact of immunization, and characterization by polymerase chain reaction with BOX primers of isolates from persistent S. pneumoniae carriers.
abstract: Pharyngeal colonization by Streptococcus pneumoniae was evaluated in 103 human immunodeficiency virus (HIV)-infected subjects (<200 CD4 cells/microL, 57; > or = 200 CD4 cells/microL, 46) and 39 non-HIV-infected controls who were participants in a vaccine study. At baseline, 7%, 20%, and 10% of subjects in the <200 and > or = 200 CD4 cell groups and in the control group were colonized with S. pneumoniae: Rates at 6 months were 23%, 22%, and 0%, respectively. Of 34 isolates from HIV-infected subjects, 25 were penicillin-resistant and 19 were resistant to > or = 3 antimicrobials; of 8 isolates from controls, 1 was resistant. Resistance to trimethoprim-sulfamethoxazole was significantly higher among HIV-infected subjects with <200 CD4 cells/microL than in those with more CD4 cells. Polymerase chain reaction DNA analysis with BOX primers demonstrated that 12 HIV-infected subjects were persistently colonized with the same S. pneumoniae strain for > or = 1 month compared with none of the controls. HIV-infected subjects were more likely to be persistent pneumococcal carriers and to carry antibiotic-resistant isolates than were non-HIV-infected subjects.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.forename: R A
authors.initials: RA
authors.lastname: Tharapel
authors.forename: J E
authors.initials: JE
authors.lastname: Groover
authors.forename: K P
authors.initials: KP
authors.lastname: Giron
authors.forename: C E
authors.initials: CE
authors.lastname: Lacke
authors.forename: E D
authors.initials: ED
authors.lastname: Houston
authors.forename: R J
authors.initials: RJ
authors.lastname: Hamill
authors.forename: M C
authors.initials: MC
authors.lastname: Steinhoff
authors.forename: D M
authors.initials: DM
authors.lastname: Musher
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002353:Carrier State; D004269:DNA, Bacterial / Q000032:analysis; D004352:Drug Resistance, Microbial; D015658:HIV Infections / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D013290:Streptococcal Infections / Q000150:complications* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000472:pathogenicity*
chemical_list: D004269:DNA, Bacterial