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Resistance of Streptococcus pneumoniae nasopharyngeal isolates from children in selected Russian orphanages: 2003 vs. 2004

Abstract number: p1388

Kozlov  R.S., Stetsiouk  O.U., Poupard  J.A., Stratchounski  L.S.

Objectives: 

Orphanages have been shown to be reservoirs of resistant strains of Streptococcus pneumoniae (SPN) which could spread to the community. A special survey was done to monitor resistance changes of SPN nasopharyngeal isolates from children living in orphanages in 2003 and one year later, in 2004.

Methods: 

This survey was performed as a part of the prospective study CORPUS in 12 orphanages (##1–12) from 5 cities (Moscow, Saint-Petersburg, Smolensk, Karachev, Bryansk) located in European part of Russia. Nasopharyngeal swabs were collected from 772 children < 7 years in 2003 and from 752 children in 2004 that yielded 399 and 397 SPN isolates respectively. Susceptibility to penicillin G (PEN), amoxicillin (AMO), amoxicillin/clavulanate (AMC), cefuroxime (CEF), cefotaxime (CTX), erythromycin (ERY), clindamycin (CLI), chloramphenicol (CHL), tetracycline (TET) and co-trimoxazole (SXT) was performed by CLSI (formerly the NCCLS) broth dilution methodology.

Results: 

SPN nasopharyngeal colonization rates were quite stable during the study period – 51.7% in 2003 and 52.8%– in 2004. There were no increase in SPN non-susceptibility (NS) or resistance (R) to PEN, AMO and AMC. However our data revealed a statistically significant increase of I and R SPN isolates to II and III generation cephalosporins (CEF and CTX) – 1.3/39.4 vs 17.9/31.2 and 3.8/2.5 vs 9.3/8.3 in 2003 vs 2004 respectively. It is noteworthy that NS SPN population to CEF increased due to the higher frequency of I isolates with the stable rate of R strains, while in the case of CTX NS – it was due to simultaneous (~2.4 fold and ~3.3 fold) increase of I and R isolates, respectively. At the same time no statistically significant changes in ERY, CLI and SXT susceptibility and statistically significant decrease in CHL R rates (15.0 vs 8.1%) were noted.

Conclusions: 

The results of the survey show stable rates of NS and R SPN nasopharyngeal isolates from children living in orphanages to penicillins, macrolides and lincosamides, tetracyclines and co-trimoxazole. Emerging resistance to II-III generation cephalosporins necessitates further evaluation of these alarming data to determine responsible risk factors and respective resistance mechanisms.

Decrease of SPN resistance to chloramphenicol can be a positive example of possibility to diminish resistance following the restricted use of antimicrobials.

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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