Skip to main content
Log in

Serogroup distribution and antimicrobial resistance of nasopharyngeal isolates of Streptococcus pneumoniae among Beijing children with upper respiratory infections (2000–2005)

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The aims of this study were to estimate pneumococcal carriage rate, antimicrobial resistance and serogroup distribution of nasopharyngeal isolates of Streptococcus pneumoniae among children with acute upper respiratory infections (AURIs) aged 1 month to 5 years attending outpatient department of the Beijing Children’s Hospital between 2000 and 2005. Susceptibilities to penicillin, amoxicillin-clavulanic acid, ceftriaxone, cefuroxime, cefaclor, erythromycin, tetracycline, sulfamethoxazole-trimethoprim and chloramphenicol were assessed using the E-test and disc diffusion. We also analyzed the correlation between antibiotic consumption and rates of resistance. The prevalence of penicillin-nonsusceptible pneumococci increased from 26% during 2000–2001 and 21% during 2002–2003 to 31.5% in 2004–2005. The percentage of S. pneumoniae resistant to cefaclor and cefuroxime increased from about 6% during 2000–2001 to about 23% during 2004–2005 (P<0.01). The frequency of resistance to erythromycin ranged from 87% to 94%. Tetracycline and co-trimoxazole resistance rates were greater than 80%. We conclude that resistance rates for most antibiotics are increasing, possibly due to misues of antibiotics in the hospital setting. However, chloramphenicol resistance was found to decrease, which correlated with the cessation of chloramphenicol administration in 1999. Pneumococcal strains (n=519) were analyzed by serogroup, and only 296 were found to be seven-valent pneumococcal conjugate vaccine-related serotype isolates. This serotype distribution is important for surveillance of the new conjugate vaccine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Felmingham D, Farrell DJ, Reinert RR, Morrissey I (2004) Antibacterial resistance among children with community-acquired respiratory tract infections (PROTEKT 1999–2000). J Infect 48:39–55

    Article  PubMed  CAS  Google Scholar 

  2. Obaro S, Adegbola R (2002) The pneumococcus: carriage, disease and conjugate vaccines. J Med Microbiol 51:98–104

    PubMed  Google Scholar 

  3. Mera RM, Miller LA, Daniels JJ, Weil JG, White AR (2005) Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States over a 10-year period: Alexander Project. Diagn Microbiol Infect Dis 51:195–200

    Article  PubMed  Google Scholar 

  4. Whitney CG, Farley MM, Hadler J, Harrison LH, Lexau C, Reingold A, Lefkowitz L, Cieslak PR, Cetron M, Zell ER, Jorgensen JH, Schuchat A, Active Bacterial Core Surveillance Program of the Emerging Infections Program Network (2000) Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. N Engl J Med 343:1917–1924

    Article  PubMed  CAS  Google Scholar 

  5. Kyaw MH, Lynfield R, Schaffner W, Craig AS, Hadler J, Reingold A, Thomas AR, Harrison LH, Bennett NM, Farley MM, Facklam RR, Jorgensen JH, Besser J, Zell ER, Schuchat A, Whitney CG, Active Bacterial Core Surveillance of the Emerging Infections Program Network (2006) Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med 354:1455–1463

    Article  PubMed  CAS  Google Scholar 

  6. Lakshman R, Murdoch C, Race G, Burkinshaw R, Shaw L, Finn A (2003) Pneumococcal nasopharyngeal carriage in children following heptavalent pneumococcal conjugate vaccination in infancy. Arch Dis Child 88:211–214

    Article  PubMed  CAS  Google Scholar 

  7. Greenberg D, Broides A, Blancovich I, Peled N, Givon-Lavi N, Dagan R (2004) Relative importance of nasopharyngeal versus oropharyngeal sampling for isolation of Streptococcus pneumoniae and Haemophilus influenzae from healthy and sick individuals varies with age. J Clin Microbiol 42:4604–4609

    Article  PubMed  Google Scholar 

  8. Yao K, Shen X, Yu S, Lu Q, Ye Q, Zhang H, Deng Q, Hu Y, Yang Y (2007) Antimicrobial resistance and serotypes of nasopharyngeal strains of Streptococcus pneumoniae in Chinese children with acute respiratory infections. J Intern Med Res 35:253–267

    CAS  Google Scholar 

  9. Sorensen UB (1993) Typing of pneumococci by using 12 pooled antisera. J Clin Microbiol 31:2097–2100

    PubMed  CAS  Google Scholar 

  10. de With K, Maier L, Steib-Bauert M, Kern P, Kern WV (2006) Trends in antibiotic use at a university hospital: defined or prescribed daily doses? Patient days or admissions as denominator? Infection 34:91–94

    Article  PubMed  Google Scholar 

  11. Malfroot A, Verhaegen J, Dubru JM, Van Kerschaver E, Leyman S (2004) A cross-sectional survey of the prevalence of Streptococcus pneumoniae nasopharyngeal carriage in Belgian infants attending day care centres. Clin Microbiol Infect 10:797–803

    Article  PubMed  CAS  Google Scholar 

  12. Sulikowska A, Grzesiowski P, Sadowy E, Fiett J, Hryniewicz W (2004) Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis isolated from the nasopharynges of asymptomatic children and molecular analysis of S. pneumoniae and H. influenzae strain replacement in the nasopharynx. J Clin Microbiol 42:3942–3949

    Article  PubMed  CAS  Google Scholar 

  13. De Lencastre H, Tomasz A (2002) From ecological reservoir to disease: the nasopharynx, day-care centres and drug-resistant clones of Streptococcus pneumoniae. J Antimicrob Chemother 50(Suppl S2):75–81

    Article  PubMed  Google Scholar 

  14. Petersen A, Andersen JS, Kaewmak T, Somsiri T, Dalsgaard A (2002) Impact of integrated fish farming on antimicrobial resistance in a pond environment. Appl Environ Microbiol 68:6036–6042

    Article  PubMed  CAS  Google Scholar 

  15. Song JH, Lee NY, Ichiyama S, Yoshida R, Hirakata Y, Fu W, Chongthaleong A, Aswapokee N, Chiu CH, Lalitha MK, Thomas K, Perera J, Yee TT, Jamal F, Warsa UC, Vinh BX, Jacobs MR, Appelbaum PC, Pai CH (1999) Spread of drug-resistant Streptococcus pneumoniae in Asian countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study. Clin Infect Dis 28:1206–1211

    Article  PubMed  CAS  Google Scholar 

  16. Ho P, Yuen K, Yam W, Sai-yin Wong S, Luk W (1995) Changing patterns of susceptibilities of blood, urinary and respiratory pathogens in Hong Kong. J Hosp Infect 31:305–317

    Article  PubMed  CAS  Google Scholar 

  17. Ho PL, Yung RW, Tsang DN, Que TL, Ho M, Seto WH, Ng TK, Yam WC, Ng WW (2001) Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother 48:659–665

    Article  PubMed  CAS  Google Scholar 

  18. Lin WJ, Lo WT, Chou CY, Chen YY, Tsai SY, Chu ML, Wang CC (2006) Antimicrobial resistance patterns and serotype distribution of invasive Streptococcus pneumoniae isolates from children in Taiwan from 1999 to 2004. Diagn Microbiol Infect Dis 56:189–196

    Article  PubMed  CAS  Google Scholar 

  19. Song JH, Chang HH, Suh JY, Ko KS, Jung SI, Oh WS, Peck KR, Lee NY, Yang Y, Chongthaleong A, Aswapokee N, Chiu CH, Lalitha MK, Perera J, Yee TT, Kumararasinghe G, Jamal F, Kamarulazaman A, Parasakthi N, Van PH, So T, Ng TK (2004) Macrolide resistance and genotypic characterization of Streptococcus pneumoniae in Asian countries: a study of the Asian Network for Surveillance of Resistant Pathogens (ANSORP). ANSORP Study Group J Antimicrob Chemother 53:457–463

    Article  PubMed  CAS  Google Scholar 

  20. Giebink GS (2001) The prevention of pneumococcal disease in children. N Engl J Med 345:1177–1183

    Article  PubMed  CAS  Google Scholar 

  21. Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A, Active Bacterial Core Surveillance of the Emerging Infections Program Network (2003) Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med 348:1737–1746

    Article  PubMed  Google Scholar 

  22. Schrag SJ, Beall B, Dowell SF (2000) Limiting the spread of resistant pneumococci: biological and epidemiologic evidence for the effectiveness of alternative interventions. Clin Microbiol Rev 13:588–601

    Article  PubMed  CAS  Google Scholar 

  23. Block SL, Hedrick J, Harrison CJ, Tyler R, Smith A, Findlay R, Keegan E (2004) Community-wide vaccination with the heptavalent pneumococcal conjugate significantly alters the microbiology of acute otitis media. Pediatr Infect Dis J 23:829–833

    Article  PubMed  Google Scholar 

  24. Lo WT, Wang CC, Yu CM, Chu ML (2003) Rate of nasopharyngeal carriage, antimicrobial resistance and serotype of Streptococcus pneumoniae among children in northern Taiwan. J Microbiol Immunol Infect 36:175–181

    PubMed  Google Scholar 

  25. Finkelstein JA, Huang SS, Daniel J, Rifas-Shiman SL, Kleinman K, Goldmann D, Pelton SI, DeMaria A, Platt R (2003) Antibiotic-resistant Streptococcus pneumoniae in the heptavalent pneumococcal conjugate vaccine era: predictors of carriage in a multicommunity sample. Pediatrics 112:862–869

    Article  PubMed  Google Scholar 

  26. Kaplan SL, Mason EO Jr, Wald ER, Schutze GE, Bradley JS, Tan TQ, Hoffman JA, Givner LB, Yogev R, Barson WJ (2004) Decrease of invasive pneumococcal infections in children among 8 children’s hospitals in the United States after the introduction of the 7-valent pneumococcal conjugate vaccine. Pediatrics 113(3 Pt 1):443–449

    Article  PubMed  Google Scholar 

  27. Gertz RE Jr, McEllistrem MC, Boxrud DJ, Li Z, Sakota V, Thompson TA, Facklam RR, Besser JM, Harrison LH, Whitney CG, Beall B (2003) Clonal distribution of invasive pneumococcal isolates from children and selected adults in the United States prior to 7-valent conjugate vaccine introduction. J Clin Microbiol 41:4194–4216

    Article  PubMed  CAS  Google Scholar 

  28. Farrell DJ, Jenkins SG, Reinert RR (2004) Global distribution of Streptococcus pneumoniae serotypes isolated from paediatric patients during 1999–2000 and the in vitro efficacy of telithromycin and comparators. J Med Microbiol 53(Pt 11):1109–1117

    Article  PubMed  CAS  Google Scholar 

  29. Huang SS, Platt R, Rifas-Shiman SL, Pelton SI, Goldmann D, Finkelstein JA (2005) Post-PCV7 changes in colonizing pneumococcal serotypes in 16 Massachusetts communities, 2001 and 2004. Pediatrics 116(3):e408–e413

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We should like to thank the following people for their support: Xiaoling Liu, Xinmiao Wei, Jinhua Chen, Yuejuan Tong, Yuan Lin, Wei Gao, Yonghong Wang and Yan Li. This work was supported financially by a grant from the National Natural Sciences Foundation of China (no. 30007093) and by a grant from the Ministry of Sciences and Technology of China (no. 2004BA720A09–01). We are also grateful to Wyeth Pharmaceuticals Inc. for their support in the preparation of this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Y. Yang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yu, S., Yao, K., Shen, X. et al. Serogroup distribution and antimicrobial resistance of nasopharyngeal isolates of Streptococcus pneumoniae among Beijing children with upper respiratory infections (2000–2005). Eur J Clin Microbiol Infect Dis 27, 649–655 (2008). https://doi.org/10.1007/s10096-008-0481-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-008-0481-y

Keywords

Navigation