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Indian Journal of Medical Microbiology, Vol. 27, No. 1, January-March, 2009, pp. 86-88 Correspondence Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae , Streptococcus pneumoniae and Moraxella catarrhalis in healthy school children in Turkey Torun MM, Namal N, Demirci M, Bahar H Department of Microbiology and Clinical Microbiology, Istanbul University, Istanbul Date of Submission: 18-Mar-2008 Code Number:mb09029 Dear Editor, The nasopharyngeal colonization of Haemophilus influenzae, Streptococus pneumoniae and Moraxella catarrhalis is a basic condition for the development of community-acquired respiratory tract infections.[1],[2],[3] As the surveillance of nasopharyngeal carriage of resistant strains is important for initiating adequate empirical antimicrobial therapy, in this study we determined the nasopharyngeal carriage rates and the in vitro antimicrobial resistance of these three respiratory tract pathogens isolated from healthy school children in Istanbul, Turkey. Nasopharyngeal samples of 330 Turkish children aged 6-10 years were collected. Samples were cultured on sheep blood agar and on chocolate agar (Oxoid, Hampshire, UK) for the isolation of S. pneumoniae and M. catarrhalis, and on chocolate agar supplemented with 19.8 U/mL bacitracin for the selective isolation of H. influenzae. The capsular typing of H. influenzae was done by slide agglutination with type-specific antiserums a to f (Difco, Detroit, USA). Susceptibility testing was performed by the agar dilution method according to NCCLS standards.[4] The production of ?-lactamase was detected by a nitrocefin disc (Becton Dickinson Microbiology Systems, NJ, USA). H. influenzae ATCC 49247 and S. pneumoniae ATCC 49619 were used as quality control organisms. The data were evaluated statistically by the Chi-square test. The prevalence of resistance in these pathogens is known to vary widely around the world, with patterns dependent on geographical area. The nasopharyngeal carriage rate of H. influenzae was determined as 32.4%, being 7.2% type b, 7.6% other capsulated and 33.9% non-capsulated strains, with a carriage peak between 6 and 7 years (36.2%). Overall, 12.9% of the H. influenzae isolates were fully resistant to ampicillin with the presence of ?-lactamase except one strain that did not react with nitrocefin and was identified as a ?-lactamase -negative ampicillin resistant (BENAR) strains. In our country, there are no comprehensive epidemiological studies on the carriage rate of S. pneumoniae and its antibiotic resistance. The majority of the studies deal with antibiotic resistance of the strains isolated from patients with clinical diseases. In our study, the nasopharyngeal carriage rate of S. pneumoniae and M. catarrhalis was determined as 29.1% and 23.9% respectively. A carriage peak between 6 and 7 years was found as 32.8% for S. pneumoniae and as 25.0% for M. catarrhalis. Twenty-five per cent of S. pneumoniae isolates showed decreased susceptibility to penicillin (18% intermediate, 7% fully resistant) and 84% of M. catarrhalis strains produced ?-lactamase [Table - 1]. As a conclusion, the resistance of H. influenzae, S. pneumoniae and M. catarrhalis could be predicted on the basis of the antimicrobial susceptibilities of pharyngeal isolates. However, the clinical use of antimicrobial agents must be restricted to avoid the increase in resistant strains. References
Copyright 2009 - Indian Journal of Medical Microbiology The following images related to this document are available:Photo images[mb09029t1.jpg] |
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