title: Antimicrobial resistance and serotype distribution of Streptococcus pneumoniae strains causing childhood infections in Bangladesh, 1993 to 1997.
abstract: Three hundred sixty-two Streptococcus pneumoniae strains were isolated from children under 5 years of age at Dhaka Shishu (Children) Hospital from 1993 to 1997. The strains were isolated from blood (n = 105), CSF (n = 164), ear swab (n = 61), eye swab (n = 20), and pus (n = 12). Of the 362 isolates, 42 (11.6%) showed intermediate resistance (MIC, <0.1 microgram/ml) and only 4 (1.1%) showed complete resistance (MIC, >2.0 microgram/ml) to penicillin. Penicillin resistance exhibited a strong relationship with serotype 14; 47.8% of the penicillin-resistant strains belonged to this type. A remarkably high (64.1%) resistance to co-trimoxazole was observed, along with a significant increase during the time period studied; there was no relationship to capsular type. By way of contrast, penicillin resistance did not show any significant change during the study period. Resistance to chloramphenicol (2.2%) and erythromycin (1.1%) was rare. The high resistance to co-trimoxazole and its increasing trend demand elucidation of the clinical impact of pneumonia treatment by this antimicrobial and reconsideration of the World Health Organization recommendation for co-trimoxazole administration to children with community-acquired pneumonia at the health care worker level in Bangladesh.
authors.affiliation: Departments of Microbiology, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. sksaha@bangla.net
authors.forename: S K
authors.initials: SK
authors.lastname: Saha
authors.forename: N
authors.initials: N
authors.lastname: Rikitomi
authors.forename: M
authors.initials: M
authors.lastname: Ruhulamin
authors.forename: H
authors.initials: H
authors.lastname: Masaki
authors.forename: M
authors.initials: M
authors.lastname: Hanif
authors.forename: M
authors.initials: M
authors.lastname: Islam
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Ahmed
authors.forename: K
authors.initials: K
authors.lastname: Matsumoto
authors.forename: R B
authors.initials: RB
authors.lastname: Sack
authors.forename: T
authors.initials: T
authors.lastname: Nagatake
mesh_terms: D001459:Bangladesh; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D006801:Humans; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000097:blood* / Q000382:microbiology; D012703:Serotyping; D013048:Specimen Handling; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology