Prevalence of antimicrobial resistance of Streptococcus pneumoniae in Chinese children: four hospitals surveillance / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the nasal carriage of antibiotic-resistant pneumococci in children of < 5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi'an.</p><p><b>METHODS</b>A total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.</p><p><b>RESULTS</b>Prevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi'an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9% - 53.8%) had a low level of resistance (MIC 0.64 - 1.5 microg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).</p><p><b>CONCLUSION</b>The rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious problems in this century.</p>

Survey of Antimicrobial Susceptibility of S.Pneumonia in Children / 中国药房

OBJECTIVE:To investigate the situation of antibiotic resistance of S.pneumoniae(Sp)of clinical isolates from children in Guangzhou.METHODS:The authors cultured,isolated and identified the Sp strains from nasopharyngeal secretion of patients who visited Guangzhou children's hospitals because of upper respiratory tract infections in2000and2001.The paper strip method and E-Test of antibiotic susceptibility were done for157isolates.RESULTS:The penicillin resistant Sp(PRSP)isolates accounted for53.5%.PRSP isolates showed a higher resistance to other?-lactam antimcrobal,erythromycin and trimethoprim/sulfamethoxazole as compared to penicillin susceptible Sp(PSSP)isolates.More than90%of PRSP were mul?tidrug resistant strains.The strains of Sp were susceptible to amoxicillin/clavulamic acid and ceftriaxone.Strains had decreaced susceptibility(59%)to cefuroxime.In2001,the rate of cefaclor resistance was56%.The prevalence of erythromycin resistant Sp in this study was up to78%.The rate of tetra-cycline resistance were87.9%.Trimethoprim/sulphamethoxazole(TMP/SMX)resistant rate was as high as69%.The chloramphenicol resistant isolats were in stable low levels(33.3%).CONCLUSI_ ON:The resistant Sp isolated from children with respiratory tract infections in this area would be a severe problem.PRSP rate was increased and was characterized by a multi-resistance to erythromycin,tetracycline and TMP/SMX.