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Trends in penicillin-resistance rates among pneumococcal carriage strains in children's day-care centres in France: 1999–2004

Abstract number: 1133_27

Roussel-Delvallez M., Laurans C., Carsenti-Dellamonica H., Dellamonica P., Pecking M., Bonnet E., Dunais B., Maurin S., Pradier C.

Objectives:  

To monitor penicillin resistance trends among nasopharyngeal (NP) carriage strains of S pneumoniae (SP) in children's day-care centres (DCC)in the wake of interventions promoting prudent antibiotic use in France.

Methods:  

Cross-sectional surveys were conducted on a random sample of children attending DCCs in 2 areas of France, Alpes Maritimes (AM) and Nord (N), in January–March 1999, 2002 and 2004. Penicillin-susceptibility and serotype of SP isolates were tested on NP aspirates. An intervention programme began in AM in October 2000 to reduce unnecessary pediatric ATB prescriptions. A large scale national campaign was launched in 2002. Pneumococcal conjugate vaccine (PCV) is reimbursed since December 2002.

Results:  

Samples were obtained from 250, 240 and 233 children in N and 298, 294 and 334 in AM in 1999, 2002 and 2004, respectively. In N, SP carriage rates (CR) remained stable from 1999 to 2002 (47% vs 49%, respectively) and decreased between 2002 and 2004 (49% vs 36%, respectively; p < 0.01). In AM, CR remained unchanged (54%, 58% and 51% in 1999, 2002 and 2004, respectively). Among SP carriers, the proportion of PDSP increased in N between 1999 and 2002 (72% vs 85%, respectively; p = 0.01) but remained stable in AM (63% and 64%, respectively). This proportion declined in both areas between 2002 and 2004 (85% vs. 60% in N, p < 10–3, and 64% vs. 43% in AM, p < 10–3, respectively). In 1999, prevalence rates of PDSP among SP carriers were similar in N (72%) and AM (63%). In 2004, this rate was lower in AM (43%) than in N (60%) (p < 0.01). In AM, there was a decrease in proportion of serotypes 23F (31% in 1999, 17% in 2002 and 9% in 2004; p < 10–3), 6B (20% in 2002 vs. 12% in 2004; p = 0.04) and 14 (15% in 2002 vs. 7% in 2004; p = 0.01) and an increase of serotype 6A (6% in 2002 vs. 15% in 2004, p < 0.01). In N, serotype 23F decreased (27% in 2002 vs. 8% in 2004; p < 0.01), and serotype 6A increased (1% in 2002 vs. 14% in 2004; p < 0.01). In 2004, at least 28% of children in N and in 36% in AM had received PCV. SP and PDSP carriage was significantly lower among vaccinees in AM (43% vs. 56% for SP; p = 0.03; and 14% vs 26% for PDSP; p = 0.01) but not in N.

Conclusion:  

A 30% decrease in proportion of PDSP among SP carriage strains from children attending DCCs has occurred since the implementation of local and national campaigns promoting judicious antibiotic use in France. Serotype distribution has shifted significantly with fewer carriers of PCV strains.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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