title: Acquisition, carriage, and transmission of pneumococci with decreased antibiotic susceptibility in young children attending a day care facility in southern Israel.
abstract: The prevalence and transmission of antimicrobial drug-resistant pneumococci was studied in 48 children attending a day care facility in southern Israel. Nasopharyngeal cultures were obtained every 2 weeks for 10 months, and antibiotic susceptibility of isolates was determined by disk diffusion and E-test. Relatedness of isolates was investigated by capsular typing, ribotyping, and arbitrarily primed polymerase chain reaction. Pneumococci were recovered during 362 (63%) of 573 fortnights, and 219 (60%) of these isolates showed decreased susceptibility to at least one drug; 154 (43%) were intermediately susceptible to penicillin and 51 (14%) were multiresistant. Combining the different typing methods showed that a limited number of clones circulated in the facility. Clones exhibiting decreased antibiotic susceptibility (especially 23F, intermediately susceptible to penicillin and resistant to trimethoprim-sulfamethoxazole, and multiresistant 6B) were more frequently isolated and persisted longer than did fully susceptible clones. By multivariate analysis, carriage of organisms with decreased antibiotic susceptibility was associated with young age, female sex, winter season, and exposure to antimicrobial drugs during the previous month.
authors.affiliation: Epidemiology Department, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: P
authors.initials: P
authors.lastname: Yagupsky
authors.forename: N
authors.initials: N
authors.lastname: Porat
authors.forename: D
authors.initials: D
authors.lastname: Fraser
authors.forename: F
authors.initials: F
authors.lastname: Prajgrod
authors.forename: M
authors.initials: M
authors.lastname: Merires
authors.forename: L
authors.initials: L
authors.lastname: McGee
authors.forename: K P
authors.initials: KP
authors.lastname: Klugman
authors.forename: R
authors.initials: R
authors.lastname: Dagan
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002353:Carrier State / Q000382:microbiology; D002656:Child Day Care Centers; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D018562:Disease Transmission, Infectious; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000635:transmission; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D012335:RNA, Ribosomal / Q000235:genetics; D012621:Seasons; D012703:Serotyping; D012737:Sex Factors; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012335:RNA, Ribosomal