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Multiple Antimicrobial Resistance of Pneumococci in Children with Otitis Media, Bacteremia, and Meningitis in Slovakia

Mary R. Reichler, Julius Rakovsky, Alica Sobotová, Margarita Sláčiková, Beata Hlaváčová, Bertha Hill, Ludmila Krajčíková, Peter Tarina, Richard R. Facklam and Robert F. Breiman
The Journal of Infectious Diseases
Vol. 171, No. 6 (Jun., 1995), pp. 1491-1496
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30135571
Page Count: 6
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Multiple Antimicrobial Resistance of Pneumococci in Children with Otitis Media, Bacteremia, and Meningitis in Slovakia
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Abstract

Penicillin-resistant pneumococci have been isolated from middle ear fluid, blood, cerebrospinal fluid, and nasopharyngeal secretions of several hundred children in Slovakia since 1985; 116 of these isolates were serotyped and tested for susceptibility to antimicrobial drugs at the Centers for Disease Control and Prevention. To define the prevalence of drug-resistant pneumococci and identify risk factors for infection, laboratory and medical records were reviewed. Nearly all (96%) of the resistant strains tested were serotype 14. Of these, all were resistant to penicillin (MIC, 4-16 µg/mL); most were resistant to cefaclor, erythromycin, tetracycline, and chloramphenicol; and many had decreased susceptibility to trimethoprim-sulfamethoxazole and ceftriaxone. Frequent antibiotic use, prior hospitalization, and length of hospital stay (P < .001 for all 3) were associated with infection with resistant strains. These findings suggest the need for routine screening of pneumococcal isolates for penicillin resistance and highlight the importance of controlling globally the spread of resistant pneumococci.

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