title: High prevalence of multi-drug resistant Streptococcus pneumoniae among healthy children in Thailand.
abstract: Antibiotic resistance in Streptococcus pneumoniae is an emerging health problem worldwide. The incidence of antimicrobial-resistant S. pneumoniae is increasing, and nasal colonization of S. pneumoniae in children increases the risk of pneumococcal infection. In this study, the prevalence of S. pneumoniae nasal colonization was studied in Thai children from three different districts. S. pneumoniae nasal colonization was found in 38 of 237 subjects (16.0%). The carriage rate indicated higher rates in two rural districts (18.2% and 29.8%) than in the urban district (2.8%). The antibiotic susceptibility pattern was determined using the disk diffusion method. Prevalence of multi-drug resistance S. pneumoniae (MDR-SP) was 31.6%. Resistance to commonly prescribed antibiotics was found for ampicillin (5.3%), azithromycin (26.3%), cefepime (2.6%), chloramphenicol (18.4%), clindamycin (18.4%), erythromycin (21.1%), oxacillin (44.7%), trimethoprim/sulfamethoxazole (78.9%) and tetracycline (15.8%). All isolates were sensitive to ceftriaxone. The pulsed-field gel electrophoresis pattern was used to compare genetic diversity of the S. pneumoniae isolates. PFGE demonstrated the variation in genotypes of S. pneumoniae from different areas. High prevalence of multi-drug resistance S. pneumoniae nasal colonization in healthy Thai children was indicated. Effective strategies for appropriate use of antibiotics are therefore needed in the community.
authors.affiliation: Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand.
authors.forename: Rapee
authors.initials: R
authors.lastname: Thummeepak
authors.affiliation: Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand.
authors.forename: Nontapat
authors.initials: N
authors.lastname: Leerach
authors.affiliation: Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand; Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand.
authors.forename: Duangkamol
authors.initials: D
authors.lastname: Kunthalert
authors.affiliation: Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand.
authors.forename: Udomsak
authors.initials: U
authors.lastname: Tangchaisuriya
authors.affiliation: Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand; Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand.
authors.forename: Aunchalee
authors.initials: A
authors.lastname: Thanwisai
authors.affiliation: Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand; Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand. Electronic address: sutthirats@nu.ac.th.
authors.forename: Sutthirat
authors.initials: S
authors.lastname: Sitthisak
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D009297:Nasal Mucosa / Q000382:microbiology; D015995:Prevalence; D012424:Rural Population; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D013785:Thailand / Q000453:epidemiology; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibacterial resistance; Children; Genotype; Nasal colonization; Streptococcus pneumoniae