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Original Articles
Pharyngeal Colonization Rate of Penicillin-resistant Streptococcus pneumoniaeamong Day-care Center Children in Seoul, Korea
Jin-Young Park, M.D. and Je-Hak Kim*
Department of Pediatrics, Sungkyunkwan University, College of Medicine*Institute of Technology & Science, Cheil Jedang Co., Seoul, Korea
Vol.31 Num.2 (p122~128)
Background:Antimicrobial resistance of Streptococcus pneumoniae presents a challenge to the clinicians in developing countries, particularly against the acute respiratory tract infections, including pneumonia. The present study was to evaluate the carriage rate and the antimicrobial resistance of S. pneumoniae isolated from children at a day-care center.
Methods:Oropharyngeal swabs were done every month for one year in 64 children at a day-care center in Seoul, Korea. Minimum inhibitory concentrations (MICs) of 9 antimicrobial agents (penicillin, ceftriaxone, cefuroxime, erythromycin, chloramphenicol, tetracycline, vancomycin, ciprofloxacin, cefpirome) were determined by agar-dilution method.
Results:The ages of the children ranged from 13 to 60 months (mean: 31 months). The overall carriage- rate of pneumococci was 26%, which was highest in December (46%) and lowest in July (3%). A total number of 105 strains of S. pneumoniae were isolated from 404 throat swabs and 68 strains among these were available for MIC tests. Only 8 (12%) strains were susceptible to penicillin, while 50 (73%) were intermediate and 10 (15%) were resistant. The isolates also exhibited high rates of resistance to other β- lactams (53% and 21% were resistant to cefuroxime and ceftriaxone, respectively). The resistance rates to the other antimicrobial agents were also remarkable; 90% and 88% were resistant to erythromycin and tetracycline, respectively. However, 75% of isolates were susceptible to chloramphenicol and 100% were susceptible to vancomycin.
Conclusion:There was a high rate of pharyngeal carriage of penicillin-resistant S. pneumoniae among children attending day-care center. Surveillance of pharyngeal cultures may provide useful information the treatment guideline of pneumococcal infections
Keywords : Streptococcus pneumoniae, Oropharyngeal infection, Carriage rate, Antimicrobial resistance