Changes in the nasal carriage of drug-resistant Streptococcus pneumoniae in urban and rural Vietnamese schoolchildren.
Studying the antimicrobial drug resistance of nasopharyngeal or nasal carriage isolates of Streptococcus pneumoniae in children is likely to have predictive potential for invasive isolates. Streptococcus pneumoniae nasal carriage was studied in 1422 Vietnamese children. Forty-six percent of 536 isolates showed reduced susceptibility to penicillin and 7% showed intermediate susceptibility to ceftriaxone; and 50% of 518 isolates showed resistance to erythromycin. All isolates were sensitive to levofloxacin and gatifloxacin. Urban and suburban children were significantly more likely to carry drug-resistant isolates than rural children. Rates of non-susceptibility to penicillin and erythromycin increased significantly in the rural province Khanh Hoa in 2003/2004 compared with rates obtained in 1997. An emerging clone of penicillin non-susceptible S. pneumoniae of serogroup 15 was identified, which was widely distributed in addition to the pandemic clones Spain(23F)-1 and Taiwan(19F)-14. Although resistance to fluoroquinolones was not observed, 6 (18%) of 34 isolates had a Lys137Asn mutation in the parC gene. This study shows that drug resistance is increasing in carriage isolates of S. pneumoniae in rural areas in Vietnam owing to spread of pandemic and emerging resistant clones.
Schultsz
Constance
C
Oxford University Clinical Research Unit at the Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam. schultsz@gmail.com
Vien
Le Minh
le M
Campbell
James I
JI
Chau
Nguyen Van Vinh
NV
Diep
To Song
TS
Hoang
Nguyen Van Minh
NV
Nga
Tran Thi Thu
TT
Savelkoul
Paul
P
Stepnieuwska
Kasia
K
Parry
Christopher
C
Hien
Tran Tinh
TT
Farrar
Jeremy J
JJ
D002353:Carrier State / Q000382:microbiology*; D002648:Child; D024881:Drug Resistance, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation; D009296:Nasal Cavity / Q000382:microbiology*; D010406:Penicillins / Q000494:pharmacology; D011110:Polymorphism, Genetic; D012423:Rural Health / Q000706:statistics & numerical data; D013290:Streptococcal Infections / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D014504:Urban Health / Q000706:statistics & numerical data; D014744:Vietnam
D010406:Penicillins