title: Risk factors for nasopharyngeal carriage of drug-resistant Streptococcus pneumoniae: data from a nation-wide surveillance study in Greece.
abstract: BACKGROUND
  A nation-wide surveillance study was conducted in Greece in order to provide a representative depiction of pneumococcal carriage in the pre-vaccination era and to evaluate potential risk factors for carriage of resistant strains in healthy preschool children attending daycare centers.
  
  
  METHODS
  A study group was organized with the responsibility to collect nasopharyngeal samples from children. Questionnaires provided demographic data, data on antibiotic consumption, family and household data, and medical history data. Pneumococcal isolates were tested for their susceptibility to various antimicrobial agents and resistant strains were serotyped.
  
  
  RESULTS
  Between February and May 2004, from a total population of 2536 healthy children, a yield of 746 pneumococci was isolated (carriage rate 29.41%). Resistance rates differed among geographic regions. Recent antibiotic use in the last month was strongly associated with the isolation of resistant pneumococci to a single or multiple antibiotics. Serotypes 19F, 14, 9V, 23F and 6B formed 70.6% of the total number of resistant strains serotyped.
  
  
  CONCLUSIONS
  Recent antibiotic use is a significant risk factor for the colonization of otherwise healthy children's nasopharynx by resistant strains of S pneumoniae. The heptavalent pneumococcal conjugate vaccine could provide coverage for a significant proportion of resistant strains in the Greek community. A combined strategy of vaccination and prudent antibiotic use could provide a means for combating pneumococcal resistance.
authors.affiliation: 4th Dept of Internal Medicine, Athens Medical School, ATTIKON University General Hospital, Athens, Greece. ikatsarolis@yahoo.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Katsarolis
authors.forename: Garyphallia
authors.initials: G
authors.lastname: Poulakou
authors.forename: Antonios
authors.initials: A
authors.lastname: Analitis
authors.forename: Irini
authors.initials: I
authors.lastname: Matthaiopoulou
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
authors.forename: Charalampos
authors.initials: C
authors.lastname: Antachopoulos
authors.forename: Dimitrios A
authors.initials: DA
authors.lastname: Kafetzis
authors.forename: Georgios L
authors.initials: GL
authors.lastname: Daikos
authors.forename: Regina
authors.initials: R
authors.lastname: Vorou
authors.forename: Christina
authors.initials: C
authors.lastname: Koubaniou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Pneumatikos
authors.forename: Georgios
authors.initials: G
authors.lastname: Samonis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Syriopoulou
authors.forename: Helen
authors.initials: H
authors.lastname: Giamarellou
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kanellakopoulou
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology*; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000453:epidemiology*; D011159:Population Surveillance; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents