title: Antimicrobial susceptibility of Streptococcus pneumoniae from children attending day-care centers in a central Italian city.
abstract: OBJECTIVE: To undertake a survey of nasopharyngeal carriage of Streptococcus pneumoniae, which reflects strains causing infection, in 100 children under 3 years of age attending day-care centers in Frosinone, a city near Rome. METHODS: Fifty-three unique isolates of S. pneumoniae, isolated from 41 of the children tested, were tested for antimicrobial susceptibility to penicillin, cefotaxime, erythromycin, clindamycin, tetracycline, chloramphenicol and trimethoprim---sulfamethoxazole. RESULTS: Resistance rates were as follows: penicillin, 20.7% (15% intermediate; 5.7% resistant); trimethoprim---sulfamethoxazole, 64.2%; erythromycin, 64.2%; clindamycin, 30.2%; tetracycline, 32.1%; and chloramphenicol, 3.8%. Except for three intermediate strains, all strains were susceptible to cefotaxime. Only five strains were susceptible to all of the antibiotics tested. An unusual finding of this study was that 23 of the 34 erythromycin-resistant strains were penicillin susceptible, whereas erythromycin-resistant strains found in other countries are predominantly penicillin resistant as well. In addition, 18 of the 34 erythromycin-resistant strains were susceptible to clindamycin. Serogroups 6, 14, 19 and 23 accounted for 84.9% of the isolates. CONCLUSIONS: These data show that carriage of antibiotic-resistant pneumococci in children under 3 years of age is high in Frosinone, Italy. Information on resistance rates in pneumococcal disease in different age groups and on prevalence of drug resistance in other parts of the country is urgently needed.
authors.affiliation: Department of Pathology, Case Western Reserve University, and University Hospitals of Cleveland, Cleveland, OH, USA.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Ronchetti
authors.forename: Rocco
authors.initials: R
authors.lastname: Merolla
authors.forename: Saralee
authors.initials: S
authors.lastname: Bajaksouzian
authors.forename: Gianni
authors.initials: G
authors.lastname: Violo
authors.forename: Roberto
authors.initials: R
authors.lastname: Ronchetti
authors.forename: Michael R.
authors.initials: MR
authors.lastname: Jacobs