title: Nasopharyngeal carriage of resistant pneumococci in young South Indian infants.
abstract: Streptococcus pneumoniae is the leading bacterial cause of life-threatening infections in infants. Although antibiotic resistance affects management of pneumococcal infections, few data on patterns of resistance are available for India. We examined nasopharyngeal carriage of antibiotic-resistant pneumococci in 464 South Indian infants between 2 and 6 months. Newly acquired serotypes were screened for susceptibility to cotrimoxazole, erythromycin and penicillin using disk diffusion. Cumulative prevalence of pneumococcal carriage rose from 53.9% at 2 months to 70.2% at 6 months. The prevalence of strains that were not susceptible to penicillin, cotrimoxazole and erythromycin was 34, 81.1 and 37.2%, respectively. Carriage of erythromycin non-susceptible strains declined significantly between ages 4 months and 6 months (44.1 vs. 10.7%). More than 87% of the isolates screened were non-susceptible to > or = 1 antibiotic. Serogroups/types that were most frequently non-susceptible to 1 or more antibiotics were 6, 9, 14, 19 and 23. Less than 1% of the isolates were multi-drug resistant. Widespread use of antibiotics in South India has resulted in S. pneumoniae becoming non-susceptible to some commonly used antibiotics. Monitoring trends in antibiotic susceptibility and making antibiotics available only through prescription from a health care worker may slow the spread of resistant pneumococci and improve management of pneumococcal infections in South India.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Coles
authors.forename: L
authors.initials: L
authors.lastname: Rahmathullah
authors.forename: R
authors.initials: R
authors.lastname: Kanungo
authors.forename: R D
authors.initials: RD
authors.lastname: Thulasiraj
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: M
authors.initials: M
authors.lastname: Santosham
authors.forename: J M
authors.initials: JM
authors.lastname: Tielsch
mesh_terms: D002353:Carrier State; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D013296:Streptococcus pneumoniae / Q000472:pathogenicity*