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Antimicrobial Agents and Chemotherapy, October 2001, p. 2765-2770, Vol. 45, No. 10
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.10.2765-2770.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Nasopharyngeal Carriage of Antimicrobial-Resistant Streptococcus pneumoniae among Young Children Attending 79 Kindergartens and Day Care Centers in Hong Kong

Susan S. Chiu,¹ Pak Leung Ho,^2,* Frankie K. H. Chow,² Kwok Yung Yuen,² and Yu Lung Lau¹

Department of Pediatrics¹ and Department of Microbiology,² University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China

Received 14 February 2001/Returned for modification 29 May 2001/Accepted 13 July 2001

Resistance to penicillin and multiple antimicrobial agents among Streptococcus pneumoniae strains is becoming an increasing problem worldwide and in Asia. To determine the prevalence of carriage of S. pneumoniae isolates not susceptible to penicillin in young children, we obtained nasopharyngeal swab specimens from 1,978 children (ages, 2 to 6 years) attending 79 day care centers or kindergartens. Three hundred eighty-three strains of S. pneumoniae were isolated from these children. Fifty-eight percent of these isolates had reduced susceptibility to penicillin, 123 (32.1%) were intermediate, and 100 (26.1%) were resistant. A very high penicillin MIC (4 µg/ml) was found in 3.3% of the isolates. The isolates also demonstrated high rates of resistance to other antimicrobial agents (51.2% to cefaclor, 50.2% to cefuroxime, 42.8% to cefotaxime, 80.7% to trimethoprim-sulfamethoxazole, 77% to erythromycin, 60% to clindamycin, and 33.7% to chloramphenicol). No isolate was resistant to fluoroquinolone. Multidrug resistance (not susceptible to the -lactams and three or more other classes) was found in 39.4% of the isolates. Risk factors for the carriage of S. pneumoniae not susceptible to penicillin were multiple physician visits in the preceding 3 months and use of antimicrobial agents by the individual or by household members in the preceding 3 months. In the logistic regression analysis, only the use of antimicrobial agents in the preceding 3 months was an independent risk factor (P = 0.004; odds ratio, 2; 95% confidence interval, 1.2 to 3.2). This study demonstrated the high prevalence of antibiotic-resistant S. pneumoniae in healthy young children in the community in Hong Kong.

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^* Corresponding author. Mailing address: Department of Microbiology, The University of Hong Kong, Pokfulam Rd., Hong Kong. Phone: (852) 28554892. Fax: (852) 28551241. E-mail: plho{at}hkucc.hku.hk.

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Antimicrobial Agents and Chemotherapy, October 2001, p. 2765-2770, Vol. 45, No. 10
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.10.2765-2770.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

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