title: Prevalence of antimicrobial resistance of Streptococcus pneumoniae in Chinese children: four hospitals surveillance.
abstract: OBJECTIVE
  To investigate the nasal carriage of antibiotic-resistant pneumococci in children of < 5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi'an.
  
  
  METHODS
  A total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.
  
  
  RESULTS
  Prevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi'an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9% - 53.8%) had a low level of resistance (MIC 0.64 - 1.5 microg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).
  
  
  CONCLUSIONS
  The rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious problems in this century.
authors.affiliation: Beijing Children's Hospital, Beijing 100045, China.
authors.forename: Xuzhuang
authors.initials: X
authors.lastname: Shen
authors.forename: Quan
authors.initials: Q
authors.lastname: Lu
authors.forename: Qici
authors.initials: Q
authors.lastname: Ye
authors.forename: Guocheng
authors.initials: G
authors.lastname: Zhang
authors.forename: Sangjie
authors.initials: S
authors.lastname: Yu
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Qiulian
authors.initials: Q
authors.lastname: Deng
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents