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Antimicrobial Agents and Chemotherapy, December 2004, p. 4618-4623, Vol. 48, No. 12
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.12.4618-4623.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Amoxicillin-Clavulanate Therapy Increases Childhood Nasal Colonization by Methicillin-Susceptible Staphylococcus aureus Strains Producing High Levels of Penicillinase

Didier Guillemot,1* Stephane Bonacorsi,2 John S. Blanchard,3,4 Philippe Weber,5 Sylvie Simon,6 Bruno Guesnon,2 Edouard Bingen,2 and Claude Carbon6

Unité des Agents Antibactériens,3 Institut Pasteur,1 Laboratoire d'Études de Génétique Bactérienne dans les Infections de l'Enfant (EA3105), Université Denis Diderot—Paris 7, Hôpital Robert-Debré (AP-HP),2 Institut National de la Santé et de la Recherche Médicale, EMI 9933, INSERM, Paris,6 BIOVSM, Vaires sur Marne, France,5 Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York4

Received 2 March 2004/ Returned for modification 24 May 2004/ Accepted 25 July 2004

We examined factors associated with penicillinase production by nasal carriage Staphylococcus aureus strains in 648 children aged 3 to 6 years attending 20 randomly sampled playschools. The children were prospectively monitored for drug use and medical events for 6 months and were then screened for S. aureus carriage. Isolates were tested for their susceptibility to penicillin G and methicillin, and penicillinase production by methicillin-susceptible, penicillin-resistant strains was quantified. S. aureus was isolated from 166 children (25.6%). Exposure to amoxicillin-clavulanate during the previous 3 months was associated with higher penicillinase production by penicillin-resistant, methicillin-susceptible strains (odds ratio, 3.6; P = 0.03). These results suggest that use of the amoxicillin-clavulanate combination could induce a herd selection process of S. aureus strains producing higher levels of penicillinase.

* Corresponding author. Mailing address: Institut Pasteur, 25-28 rue du Dr. Roux, 75724 Paris Cedex 15, France. Phone: 33 1 45 68 82 99. Fax: 33 1 45 68 82 04. E-mail: guillemo{at}pasteur.fr.

Antimicrobial Agents and Chemotherapy, December 2004, p. 4618-4623, Vol. 48, No. 12
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.12.4618-4623.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.





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