Skull SA; Leach AJ; Currie BJ

Author(s)

Skull SA

Leach AJ

Currie BJ

Publication Date

1996-06

Abstract

The prevalence of resistant Streptococcus pneumoniae (SP) is increasing world-wide. Pneumococcal prevalence and susceptibility patterns are not known for children in the Top End of the Northern Territory. To determine the prevalence of nasopharyngeal carriage of pneumococci in children hospitalised in Darwin, and the extent of penicillin and ceftriaxone resistance in these isolates. Nasopharyngeal swabs were collected on admission from 85 children who had not received antimicrobials for their admission illness. Antimicrobial resistance was determined following selective culture for SP isolates. Minimal inhibitory concentrations (MICs) for penicillin and ceftriaxone were determined using the E-test method. The overall prevalence of nasopharyngeal SP carriage was 44%. Carriage occurred more often in Aboriginal children from rural areas (56%) than in urban children (24%) (OR 3.94, 95% CI 1.35-11.78, p < 0.01). Thirty per cent of isolates were penicillin resistant, 35% were ceftriaxone resistant, and 49% were resistant to at least one of these. One isolate showed high-level resistance to both antimicrobials; all other resistant isolates were of intermediate-level resistance. For the same isolate, MICs for ceftriaxone were more often higher than those for penicillin. Five isolates had intermediate resistance to ceftriaxone whilst remaining sensitive to penicillin. The prevalence of pneumococcal resistance to penicillin and ceftriaxone in hospitalised children in Darwin is much higher than previously reported in Australia. This has implications for future antimicrobial management and highlights the need for regular regional surveillance of SP resistance. The development of conjugate pneumococcal vaccines for children under two years is a priority.

Citation

Australian and New Zealand journal of medicine 1996-06; 26(3): 391-5

ISSN

0004-8291

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/8811214/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/6890

MESH subject

Ceftriaxone

Child

Child, Preschool

Cohort Studies

Female

Humans

Infant

Infant, Newborn

Male

Microbial Sensitivity Tests

Nasopharynx

Northern Territory

Oceanic Ancestry Group

Pneumococcal Infections

Prevalence

Streptococcus pneumoniae

Cephalosporin Resistance

Penicillin Resistance

Title

Streptococcus pneumoniae carriage and penicillin/ceftriaxone resistance in hospitalised children in Darwin.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Skull SA Leach AJ Currie BJ
Publication Date	1996-06
Abstract	The prevalence of resistant Streptococcus pneumoniae (SP) is increasing world-wide. Pneumococcal prevalence and susceptibility patterns are not known for children in the Top End of the Northern Territory. To determine the prevalence of nasopharyngeal carriage of pneumococci in children hospitalised in Darwin, and the extent of penicillin and ceftriaxone resistance in these isolates. Nasopharyngeal swabs were collected on admission from 85 children who had not received antimicrobials for their admission illness. Antimicrobial resistance was determined following selective culture for SP isolates. Minimal inhibitory concentrations (MICs) for penicillin and ceftriaxone were determined using the E-test method. The overall prevalence of nasopharyngeal SP carriage was 44%. Carriage occurred more often in Aboriginal children from rural areas (56%) than in urban children (24%) (OR 3.94, 95% CI 1.35-11.78, p < 0.01). Thirty per cent of isolates were penicillin resistant, 35% were ceftriaxone resistant, and 49% were resistant to at least one of these. One isolate showed high-level resistance to both antimicrobials; all other resistant isolates were of intermediate-level resistance. For the same isolate, MICs for ceftriaxone were more often higher than those for penicillin. Five isolates had intermediate resistance to ceftriaxone whilst remaining sensitive to penicillin. The prevalence of pneumococcal resistance to penicillin and ceftriaxone in hospitalised children in Darwin is much higher than previously reported in Australia. This has implications for future antimicrobial management and highlights the need for regular regional surveillance of SP resistance. The development of conjugate pneumococcal vaccines for children under two years is a priority.
Citation	Australian and New Zealand journal of medicine 1996-06; 26(3): 391-5
ISSN	0004-8291
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/8811214/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/6890
MESH subject	Ceftriaxone Child Child, Preschool Cohort Studies Female Humans Infant Infant, Newborn Male Microbial Sensitivity Tests Nasopharynx Northern Territory Oceanic Ancestry Group Pneumococcal Infections Prevalence Streptococcus pneumoniae Cephalosporin Resistance Penicillin Resistance
Title	Streptococcus pneumoniae carriage and penicillin/ceftriaxone resistance in hospitalised children in Darwin.
Type of document	Journal Article
Entity Type	Publication

Streptococcus pneumoniae carriage and penicillin/ceftriaxone resistance in hospitalised children in Darwin.

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