Antimicrobial susceptibility in respiratory bacterial pathogens among children in Greenland: little antibiotic resistance in spite of high antibiotic use

Abstract number: 1134_03_228

Koch A., Tvede M., Høgh Andersen L., Hjuler T., Melbye M.

Objectives:  

In Alaskan natives the prevalence of penicillin-resistant S. pneumoniae isolates is high. In Greenland respiratory tract infections in children are frequent, and antibiotic use is high. As local data on antimicrobial resistance hardly exist in Greenland, the objective of his study was to obtain such information.

Methods:  

A population-based cohort of children aged 0–4 years was followed in Sisimiut, Greenland, for a two-year period (1996 -1998). Throat swabs were taken when symptoms of respiratory tract infection presented and every half-year without symptoms. In case of acute purulent ear discharge a swab was taken from the middle ear. Swabs were placed in Stuart's transport medium and sent by airmail to the University Hospital, Copenhagen, for culturing. Antibiotic susceptibility was determined by the disk diffusion method with Danish Blood Agar and Rosco New Sensitabs. Antimicrobial susceptibility was defined as susceptible, intermediate, or resistant. Only the first isolate from each child was used for analysis.

Results:  

Overall, 1624 swabs from 376 children (81% of cohort) were cultured and 2560 isolates identified. All S. pneumoniae (n = 153) Isolates were susceptible to Penicillin, Ampicillin, Erythromycin and other drugs tested. Only 1 of all 270 S. pneumoniae isolates was inter-mediately susceptible to Penicillin. Of 237 H. influenzae isolates 92% were susceptible to Ampicillin, and 94% susceptible to Erythromycin. All Ampicillin resistant strains were beta-lactamase producing. Of 228 beta-haemolytic streptococcal isolates 98% were susceptible to Erythromycin. Of 35 Moraxella spp. isolates 49% were susceptible to Ampicillin and 51% resistant, while 100% were susceptible to Erythromycin. There was no Meticillin resistant S. aureus (MRSA). The distribution was unchanged if only throat swabs were analysed.

Conclusions:  

Antibiotic resistance is low in Greenland and similar to that in Scandinavia. With respect to Penicillin, resistance is less in Greenland than in Alaskan natives. Surveillance of antimicrobial susceptibility in Greenland is warranted. In 2000 Greenland joined the International Circumpolar Surveillance of infectious diseases.