The Spread of Multiply Resistant Streptococcus pneumoniae at a Day Care Center in Ohio

Streptococcus pneumoniae, type 23F, resistant to penicillin (MIC, 2 µg/mL) and multiple other antimicrobic agents, was isolated from middle ear fluid of a child with otitis media attending a day care center in Ohio. To determine the extent of spread of this strain, nasopharyngeal culture surveys wer...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-12, Vol.166 (6), p.1346-1353
Main Authors: Reichler, Mary R., Allphin, Allan A., Breiman, Robert F., Schreiber, John R., Arnold, James E., McDougal, Linda K., Facklam, Richard R., Boxerbaum, Bernard, May, Daniel, Walton, Robert O., Jacobs, Michael R.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Antibiotics
Antimicrobials
Carrier State - drug therapy
Carrier State - epidemiology
Carrier State - microbiology
Child
Child Day Care Centers
Child health services
Child, Preschool
Children
Day care centers
Disease resistance
Drug Resistance, Microbial
Epidemiology
Erythromycin Ethylsuccinate - therapeutic use
Humans
Infant
Major Articles
Nasopharynx - microbiology
Ohio - epidemiology
Otitis media
Otitis Media - epidemiology
Otitis Media - microbiology
Otitis Media - prevention & control
Penicillin
Penicillin Resistance
Pneumococcal Infections - drug therapy
Pneumococcal Infections - epidemiology
Pneumococcal Infections - microbiology
Rifampin - therapeutic use
Risk Factors
Streptococcus pneumoniae
Streptococcus pneumoniae - drug effects
Streptococcus pneumoniae - isolation & purification
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Description
Summary:Streptococcus pneumoniae, type 23F, resistant to penicillin (MIC, 2 µg/mL) and multiple other antimicrobic agents, was isolated from middle ear fluid of a child with otitis media attending a day care center in Ohio. To determine the extent of spread of this strain, nasopharyngeal culture surveys were done, and 52 carriers were identified among 250 children attending the index day care center. No carriers were found among 121 children at two other day care centers in the same urban area. Use of prophylactic doses of antibiotics (P < .001) and frequent use of antibiotics (P < .001) were risk factors for nasopharyngeal carriage. Carriers were more likely to have had frequent otitis media episodes (P < .02) and otitis media not responsive to antimicrobial therapy (P < .001). Strategies to limit the spread of highlyresistant pneumococcal strains should include encouraging judicious use of antimicrobic agents and reevaluating indications for prophylactic use of antimicrobic agents.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/166.6.1346