สถาบันวิจัยวิทยาศาสตร์สาธารณสุข

NATIONAL INSTITUTE OF HEALTH OF THAILAND

Nasopharyngeal Carriage and Antimicrobial Susceptibility of Streptococcus pneumoniae in Children with Acute Respiratory Tract Infection, Thailand, 1993-2000

Authors : Mayura Kusum*, Surang Dejsirilert*,Leelawadee Sangsook*

 

Affiliations:        *Department of Medical Sciences. Tiwanond Road, Nonthaburi 11000, Thailand
 
Source:             Intern Med J Thai 2003; 19: 251-256
 
Language:         English
 
Abstract:
 
Pneumoniae has been the leading cause of death among bacterial infectious diseases are caused mainly by Streptococcus pneumoniae (SP). Penicillin had once long been the most active drug for treating SP infection, but today increasing rates of penicillin-resistant pneumococci have been reported worldwide. The choice of proper antimicrobial treatment requires knowledge of antimicrobial susceptibility patterns. This surveillance project was set up to determine the carriage rate and resistance patterns of SP from the nasopharynx of children under 5 years old who had acute respiratory tract infection (ARI). For the initial period, the surveillance was conducted every year in 1993 and 1994 then every third year in 1997 and 2000. Six urban hospitals representing six regions of Thailand participated in the project. Under the supervision of pediatricians, nasopharyngeal swabs were obtained from children under 5 years of age with ARI who attended those hospitals. SP isolation and antimicrobial sensitivity tests were undertaken, according to the recommendations of the National Committee of Clinical Laboratory Standards (NCCLS) as the standard for determination. During the period 1993-2000, the nasopharyngeal carriage rate in children under 5 year of age was 37 per cent on average , with no significant change by year . The carriage rate in children with upper respiratory tract infection was higher (45%) than in cases of pneumonia (29%).Penicillin resistant pneumococci (MIC³ 0.1mg/mL) increased from 37 to 61 per cent during the seven-year period. There was no resistance to ofloxacin but intermediate resistance was high at 44.7 per cent. Cotrimoxazole resistance and multidrug resistance also increased. These findingscall attention to the importance of establishing strategies to minimize antimicrobial resistance and the necessity of performing continuous surveillance.