High prevalence of multidrug-resistant Streptococcus pneumoniae among children in a rural Kentucky community

Pediatr Infect Dis J. 1995 Sep;14(9):745-50. doi: 10.1097/00006454-199509000-00004.


In 1992 drug-resistant Streptococcus pneumoniae was cultured with increasing frequency from aspirates of middle ear fluid from children with acute otitis media in a rural Kentucky community. To determine the prevalence of carriage of drug-resistant S. pneumoniae in the community, we obtained nasopharyngeal swabs from 158 (70%) of 227 children attending a child daycare center and from 82 children attending the county health center. S. pneumoniae was isolated from 126 children. Among 123 isolates tested 65 (53%) were penicillin-resistant, including 41 (33%) strains that were highly resistant; 61 (50%) were multidrug-resistant. Serotypes 19F, 6B, 23F and 6A comprised 89% of the penicillin-resistant isolates. Detection of a variety of serotypes and drug resistance patterns among nasopharyngeal isolates of S. pneumoniae suggests that multidrug-resistant pneumococcal strains are endemic in this community. Surveillance for drug-resistant pneumococci with the use of respiratory secretions obtained by nasopharyngeal swab may provide useful information on the prevalence of drug-resistant strains causing invasive disease and otitis media. Such information could be used to guide empiric therapy of pneumococcal infections.

MeSH terms

  • Carrier State / epidemiology*
  • Child
  • Child Day Care Centers
  • Child, Preschool
  • Drug Resistance, Microbial*
  • Drug Resistance, Multiple*
  • Humans
  • Infant
  • Kentucky / epidemiology
  • Logistic Models
  • Microbial Sensitivity Tests
  • Nasopharynx / microbiology
  • Otitis Media with Effusion / drug therapy
  • Otitis Media with Effusion / microbiology
  • Pneumococcal Infections* / drug therapy
  • Pneumococcal Infections* / epidemiology
  • Prevalence
  • Rural Population
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / isolation & purification