title: Antimicrobial susceptibility and serotypes of nasopharyngeal Streptococcus pneumoniae in children with pneumonia and in children attending day-care centres in Fortaleza, Brazil.
abstract: The susceptibility of nasopharyngeal Streptococcus pneumoniae to eight antibiotics was studied in 482 children under 5 years of age with community-acquired pneumonia and in 429 healthy pneumococci carriers in Fortaleza, Brazil. Serotyping of strains with pooled and type-specific antisera was also performed. Overall, S. pneumoniae was isolated from 499/911 (55%) children. The carriage rate in children attending day-care centres was higher (72%) than in children with pneumonia (50%) (P<0.001). MIC determination in 441 strains revealed 45% to be intermediate penicillin-resistant and 4% high penicillin-resistant strains. Resistance rates to co-trimoxazole and erythromycin were 42 and 23%, respectively. Serotyping of 211 penicillin-resistant and 58 randomly selected penicillin-susceptible isolates showed that 78% of the strains belonged to paediatric serogroups 6, 14, 19 and 23 (86% of the penicillin-resistant and 51% of the penicillin-susceptible strains, P=0.001). Resistance rates of S. pneumoniae to penicillin and co-trimoxazole in Fortaleza were higher than previously reported in Brazil and associated with paediatric serogroups 6, 14, 19 and 23.
authors.affiliation: University Hospital, Federal University of Ceara, Av. Rui Barbosa 2100/502, CEP 60.115-222, Fortaleza, CE, Brazil. reyfonte@uol.com.br
authors.forename: Luis C
authors.initials: LC
authors.lastname: Rey
authors.forename: Bart
authors.initials: B
authors.lastname: Wolf
authors.forename: J Luciano B
authors.initials: JL
authors.lastname: Moreira
authors.forename: Dana
authors.initials: D
authors.lastname: Milatovic
authors.forename: Jan
authors.initials: J
authors.lastname: Verhoef
authors.forename: Calil K
authors.initials: CK
authors.lastname: Farhat
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002656:Child Day Care Centers; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology*; D010403:Penicillin Resistance; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents