Risk factors for carriage of drug-resistant Streptococcus pneumoniae among children in Memphis, Tennessee

J Pediatr. 1996 Jun;128(6):757-64. doi: 10.1016/s0022-3476(96)70326-8.

Abstract

Objectives: To determine risk factors for carriage of drug-resistant Streptococcus pneumoniae to understand better the factors promoting spread of these isolates.

Study design: We obtained medical and demographic information and nasopharyngeal swab specimens from 216 children less than 6 years old with upper respiratory tract infections, seeking medical care at five Memphis, Tenn, study sites. We evaluated risk factors for carriage of penicillin-nonsusceptible S. pneumoniae (NSSP) among 100 children with S. pneumoniae isolates. Patterns of antimicrobial prescription were recorded for enrolled children.

Results: Independent risk factors for carriage of NSSP included an increased number of antimicrobial treatment courses during the previous 3 months and white race. Day care attendance approached statistical significance (p = 0.07). Most children with upper respiratory tract infection received a prescription for antimicrobial drugs. These prescriptions were more common for white children than for black children.

Conclusions: Increased use of antimicrobial drugs enhances the risk of carriage of NSSP. This may contribute to the higher risk among white children of NSSP infection; however, after control for antimicrobial use, white children were still at an increased risk of infection with NSSP, possibly through greater exposure to resistant strains.

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Carrier State / drug therapy*
  • Carrier State / microbiology
  • Child, Preschool
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Nasopharynx / microbiology
  • Penicillin Resistance*
  • Pneumococcal Infections / drug therapy*
  • Pneumococcal Infections / microbiology
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / microbiology
  • Risk Factors
  • Streptococcus pneumoniae / drug effects*
  • Tennessee / epidemiology

Substances

  • Anti-Bacterial Agents