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Abstract
BackgroundDuring the past decades Streptococcus pneumoniae has developed significant resistance to many classes of antimicrobial drugs. Potential risk factors for colonization of the nasopharynx by Streptococcus pneumoniae in children and for carriage of drug resistant strains were examined.MethodsBetween 2007 and 2008 nasopharyngeal swabs were collected from 402 children 6 months to 5 years old visiting the public sector immunization centers and outpatient departments as well as offices of paediatricians from private practice in Nicosia district in Cyprus. Information on demographic characteristics and potential risk factors of participating children were collected using a standardized questionnaire distributed to parents.ResultsIn multivariable analyses we found that attendance at day care center, having siblings in the family and having both parents originating from Cyprus, statistically increased the risk of pneumococcal colonization. Full immunization with PCV7 appears to be a protective factor against colonization by pneumococcus. Previous administration of antimicrobials during the last month prior to specimen collection appeared to be the most consistent risk factor for carrying a non susceptible strain of Streptococcus pneumoniae to either penicillin or erythromycin. Factors such as age, nationality, previous or current breastfeeding, passive exposure to cigarette smoke and attendance in a day care center do not appear as independent risk factors for colonization by non susceptible strains.ConclusionsPrudent use of antibiotics especially for upper respiratory tract infections in children as well as increased vaccination coverage by the pneumococcal conjugate vaccines could prove effective in reducing levels of colonization by drug resistant pneumococcal strains.
Highlights
During the past decades Streptococcus pneumoniae has developed significant resistance to many classes of antimicrobial drugs
Colonization of the nasopharynx by S. pneumoniae is considered a prerequisite for invasive disease and has a key role in the transmission of the pathogen to other individuals leading to pathogen spread in the community [2, 3]
Development of pneumococcal conjugate vaccines has led to a significant decrease of pneumococcal infections in general and to infections caused by drug resistant strains [6]
Summary
During the past decades Streptococcus pneumoniae has developed significant resistance to many classes of antimicrobial drugs. Streptococcus pneumoniae is a common cause of meningitis, pneumonia and bacteraemia among children and the elderly. Global development of resistance of S. pneumoniae to several antimicrobials appears to pose a significant challenge to the successful treatment of infections [5]. Development of pneumococcal conjugate vaccines has led to a significant decrease of pneumococcal infections in general and to infections caused by drug resistant strains [6]. Conjugate vaccines act by decreasing infections caused by vaccine serotypes They reduce colonization by the same serotypes; a result which appears to account for a significant herd effect noted in older age groups who have not been vaccinated [7]
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