Colonization with antibiotic-resistant Streptococcus pneumoniae in children with sickle cell disease

Steele, Russell W., Warrier, Rajasekharan, Unkel, Patrick J., Foch, Bertrand J., Howes, Richard F., Shah, Sanjay, Williams, Karen, Moore, Sheila and Jue, Sue J. (1996) Colonization with antibiotic-resistant Streptococcus pneumoniae in children with sickle cell disease. Journal of Pediatrics, 128 4: 531-535. doi:10.1016/S0022-3476(96)70365-7


Author Steele, Russell W.
Warrier, Rajasekharan
Unkel, Patrick J.
Foch, Bertrand J.
Howes, Richard F.
Shah, Sanjay
Williams, Karen
Moore, Sheila
Jue, Sue J.
Title Colonization with antibiotic-resistant Streptococcus pneumoniae in children with sickle cell disease
Formatted title
Colonization with antibiotic-resistant Streptococcus pneumoniae in children with sickle cell disease
Journal name Journal of Pediatrics   Check publisher's open access policy
ISSN 0022-3476
1097-6833
Publication date 1996-04-01
Year available 1996
Sub-type Article (original research)
DOI 10.1016/S0022-3476(96)70365-7
Open Access Status Not Open Access
Volume 128
Issue 4
Start page 531
End page 535
Total pages 5
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
OBJECTIVE: Because of a susceptibility to severe pneumococcal infection, children with sicklecelldisease (SCD) routinely receive penicillin prophylaxis. Increasing rates of penicillin resistance have been reported throughout the world. Our objective was to assess the prevalence of nasopharyngeal colonization with Streptococcus pneumoniae and to assess the antimicrobial susceptibility of the organisms in children with SCD. STUDY DESIGN: Nasopharyngeal cultures for S. pneumoniae were obtained from all children with SCD attending clinics in a statewide university-based network. Background colonization rates were determined in children attending day care centers in some of the same locations. All recovered S. pneumoniae organisms were tested for susceptibility to penicillin, and all resistant strains were examined for susceptibility to other antibiotics. RESULTS: Overall nasopharyngeal pneumococcal colonization rates among children with SCD were 12%. Colonization was associated with age less than 2 years (p <0.001) and day care attendance for more than 20 hr/wk (p = 0.00005). More than half of these strains (62%) were resistant to penicillin, 33% having intermediate resistance (minimal inhibitory concentration 0.06 to 1 μg/ml) and 29%, high level resistance (minimal inhibitory concentration ≥2.0 μg/ml). Penicillin resistance was associated with penicillin prophylaxis (p <0.01). Many of these organisms were also resistant to other classes of antibiotics. CONCLUSIONS: Although penicillin prophylaxis and pneumococcal vaccine for patients with SCD have reduced overall nasopharyngeal colonization and disease caused by S. pneumoniae (p <0.001), a higher percentage of colonizing strains are now resistant both to penicillin and to other antimicrobial agents (p <0.01). Newer strategies for preventing disease and early management of suspected pneumococcal infection in these children must be developed.
Keyword MIC
Minimal inhibitory concentration
TMP-SMX
Trimethoprim-sulfamethoxazole
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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