Ridgway E J, Tremlett C H, Allen K D
Department of Microbiology, Whiston Hospital, Prescot, Merseyside, U.K.
J Infect. 1995 May;30(3):245-51. doi: 10.1016/s0163-4453(95)90831-5.
A total of 1049 primary-school children in 18 schools were screened for carriage of Streptococcus pneumoniae. Data on family size, antibiotic use, travel and hospital admissions were collected. Pneumococcal serotyping and sensitivity tests were performed. One third of children were found to be pneumococcal carriers. Ten of 344 isolates were penicillin-resistant (2.9%). Apart from resistance to trimethoprim and ciprofloxacin, resistance rates in penicillin-sensitive strains were low. Among penicillin-resistant strains (PRP), co-resistance to trimethoprim, chloramphenicol and tetracycline was common. Cefotaxime-resistance was seen in 90% of PRP. Although 24 serotypes were represented, groups 6, 19 and 23 accounted for 55% of strains. Serogroup 23 strains were significantly more likely to be penicillin-resistant than other groups/types. Clustering of strains by serotype and antibiotic resistance was seen in several schools. No association with foreign travel, family size or age of siblings was seen and penicillin resistance was not associated with prior antibiotic use. However, hospital admission was significantly associated with carriage of PRP. The implications of detecting PRP in the community are discussed.
对18所学校的1049名小学生进行了肺炎链球菌携带情况筛查。收集了家庭规模、抗生素使用、旅行和住院情况的数据。进行了肺炎球菌血清分型和药敏试验。发现三分之一的儿童为肺炎球菌携带者。344株分离株中有10株对青霉素耐药（2.9%）。除对甲氧苄啶和环丙沙星耐药外，青霉素敏感菌株的耐药率较低。在耐青霉素菌株（PRP）中，对甲氧苄啶、氯霉素和四环素的共同耐药很常见。90%的PRP对头孢噻肟耐药。虽然有24种血清型，但6、19和23组占菌株的55%。23血清群菌株比其他组/型更易对青霉素耐药。在几所学校中发现了菌株按血清型和抗生素耐药性的聚集现象。未发现与出国旅行、家庭规模或兄弟姐妹年龄有关，青霉素耐药与先前使用抗生素无关。然而，住院与PRP携带显著相关。讨论了在社区中检测到PRP的意义。
