Patterns of antibiotic-resistant Streptococcus pneumoniae in children in a day-care setting

J Fam Pract. 1998 Feb;46(2):142-6.


Background: Streptococcus pneumoniae is one of the primary causes of illness and death among young children, and evidence suggests that the prevalence of antibiotic-resistant S pneumoniae is increasing. The purpose of this study was to investigate the prevalence of antibiotic-resistant S pneumoniae in a sample of children in day-care facilities in a region that includes both rural and urban communities.

Methods: Nasopharyngeal cultures were obtained from 104 children in eight day-care centers located in rural and urban central Kentucky in April and May, 1997. Thirty-five of the children produced isolates positive for S pneumoniae. Each isolate was tested for susceptibility to penicillin, trimethoprim-sulfamethoxazole, erythromycin, tetracycline, vancomycin, and cefotaxime.

Results: Of the children with S pneumoniae isolates, 54% had isolates that were resistant to penicillin and 40% that were resistant to trimethoprim-sulfamethoxazole. Twenty-one (60%) of the isolates had resistance to at least one of the six tested antimicrobials, with 15 (43%) having resistance to more than one of the antimicrobials. The mean age of children with isolates resistant to penicillin was significantly less (2.7 + 1.6) than those with penicillin-susceptible isolates (3.7 + 1.1, P = .02). There was no relation between resistance and rural or urban day-care location.

Conclusions: A substantial proportion of S pneumoniae isolates in young children are resistant to antibiotics. Limiting the effect of S pneumoniae drug resistance may require a reexamination of outpatient treatment strategies for childhood respiratory tract infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child Day Care Centers*
  • Child, Preschool
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Infant
  • Kentucky
  • Male
  • Nasopharynx / microbiology
  • Penicillin Resistance
  • Streptococcus pneumoniae / drug effects*