[Antibiotic resistance of streptococcus pneumoniae among healthy nasopharyngeal carriers in seven regions of Peru].
OBJECTIVE
To determine the pattern of antibiotic susceptibility of isolated Streptococcus pneumoniae strains of healthy nasopharyngeal carriers younger than 2 years in seven regions of Peru.


METHODS
Between 2007 and 2009, nasopharyngeal swab samples were collected among 2123 healthy children aged 2-24 months in growth and development medical practices (CRED) and vaccination offices of hospitals and health centers in Lima, Piura, Cusco, Abancay, Arequipa, Huancayo, and Iquitos. The resistance to ten antibiotics through disk diffusion sensitivity testing of isolated pneumococcus strains was determined.


RESULTS
572 strains were isolated. High rates of resistance to co-trimoxazole (58%), penicillin (52.2% non-sensitive); tetracycline (29,1%); azithromycin (28,9%), and erythromycin (26,3%). Resistance to chloramphenicol was low (8.8%). Multiresistance was found at 29.5%. Resistance to azithromycin and penicillin was different in all seven regions (p<0,05), the highest percentage of non-sensitive strains being found in Arequipa (63,6%), whereas the lowest percentage was found in Cusco (23.4%).


CONCLUSIONS
High levels of resistance found to penicillin, co-trimoxasole and macrolides in isolated pneumococcus strains of healthy carriers in all studied regions, and their association to a previous use of antibiotics, represent a significant public health problem in our country. This emphasizes the need to implement nationwide strategies to reduce the irrational use of antibiotics, especially among children. It is necessary to complement data of resistance to penicillin with the determination of minimal inhibitory concentration to make proper therapeutic recommendations.
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Nancy
N
Torres
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Ricardo
R
Velásquez
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Erik H
EH
Mercado
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Martha
M
Egoavil
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
Gertrudis
G
Horna
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
Lida
L
Mejía
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
María E
ME
Castillo
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Eduardo
E
Chaparro
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Roger
R
Hernández
Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
Wilda
W
Silva
Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú
Francisco E
FE
Campos
Hospital Nacional Daniel A. Carrión, Lima, Perú
Andrés
A
Sáenz
Hospital Regional del Cusco, Cusco, Perú
Félix
F
Hidalgo
Hospital Regional del Cusco, Cusco, Perú
Carolina
C
Letona
Hospital Guillermo Díaz de la Vega, Abancay, Perú
Angel G
AG
Valencia
Hospital EsSalud de Yanahuara, Arequipa, Perú
Rosario
R
Cerpa
Policlínico Metropolitano de Arequipa, Arequipa, Perú
Bernardo
B
López-de-Romaña
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Berenice
B
Torres
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Fiorella
F
Castillo
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Andrea
A
Calle
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Synthia
S
Rabanal
Department of Pediatrics and Child Health, University College Cork, Cork, Irlanda.
Jackeline
J
Pando
Centro de Salud Urubamba, Cusco, Perú
Elizabeth
E
Lacroix
Hospitalde Emergencias Pediátricas, Lima, Perú
Isabel
I
Reyes
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
Humberto
H
Guerra
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
Theresa J
TJ
Ochoa
D002353:Carrier State; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology*; D010568:Peru; D013296:Streptococcus pneumoniae / Q000187:drug effects*