OBJECTIVE:To investigate the situation of antibiotic resistance of S.pneumoniae(Sp)of clinical isolates from children in Guangzhou.METHODS:The authors cultured,isolated and identified the Sp strains from nasopharyngeal secretion of patients who visited Guangzhou children's hospitals because of upper respiratory tract infections in2000and2001.The paper strip method and E-Test of antibiotic susceptibility were done for157isolates.RESULTS:The penicillin resistant Sp(PRSP)isolates accounted for53.5%.PRSP isolates showed a higher resistance to other?-lactam antimcrobal,erythromycin and trimethoprim/sulfamethoxazole as compared to penicillin susceptible Sp(PSSP)isolates.More than90%of PRSP were mul?tidrug resistant strains.The strains of Sp were susceptible to amoxicillin/clavulamic acid and ceftriaxone.Strains had decreaced susceptibility(59%)to cefuroxime.In2001,the rate of cefaclor resistance was56%.The prevalence of erythromycin resistant Sp in this study was up to78%.The rate of tetra-cycline resistance were87.9%.Trimethoprim/sulphamethoxazole(TMP/SMX)resistant rate was as high as69%.The chloramphenicol resistant isolats were in stable low levels(33.3%).CONCLUSI_ ON:The resistant Sp isolated from children with respiratory tract infections in this area would be a severe problem.PRSP rate was increased and was characterized by a multi-resistance to erythromycin,tetracycline and TMP/SMX.

OBJECTIVETo investigate the nasal carriage of antibiotic-resistant pneumococci in children of < 5 years old in the following four cities, Beijing, Shanghai, Guangzhou and Xi'an.

METHODSA total of 647 pneumococci strains were isolated and detected. Minimal inhibition concentrations (MICs) of antibiotics were determined by E-test. Disk diffusion test was used for the measurement of antimicrobial susceptibility.

RESULTSPrevalence of penicillin non-susceptible Streptococcus pneumoniae in the four cities was 41%, with Guangzhou (60.8%) ranking first, followed by Xi'an (45%), Shanghai (37%) and Beijing (25.9%). The majority of penicillin non-susceptibility isolates (23.9% - 53.8%) had a low level of resistance (MIC 0.64 - 1.5 microg/ml). The most sensitive antimicrobials in terms of percentage of susceptible organisms were amoxicillin-clavulanic acid (99.4%), followed by ceftriaxone (92.1%); cefurxime and cefaclor were slightly more sensitive than penicillin with susceptibility of 74.8% and 77.9%. Erythromycin, tetracycline and TMP-SMZ were highly resistant (83.6%, 82.1% and 76.2% respectively). Among erythromycin resistant isolates, 100% were resistant to azithromycin, 98.6% to clarithromycin, 97.2% to roxithromycin and spiramycin, and 96.6% to clindamycin. 97.2% (141/145) were typical of the macrolides-lincosamides-streptogramons B (MLSB) resistance phenotype, and 2.8% (4/145) were M phenotype. The group of PRSP was with significantly higher rates of non-susceptibility for ceftriaxone (18.4%), cefurxime (58.6%), cefaclor (53.4%), compared with the group of PEN-S (0.5%, 1.8% and 0.2%, respectively) and the rate of multi-drug resistance in the isolates of PRSP group (92.9%) was significantly higher than that of PEN-S group (59.2%).

CONCLUSIONThe rates of penicillin and multi-drug resistance among isolates of pneumococci carried nasally in are high children and the high prevalence of multi-drug resistance in the Chinese population may be becoming one of the most serious problems in this century.

Anti-Bacterial Agents ; pharmacology ; Child, Preschool ; China ; epidemiology ; Drug Resistance, Bacterial ; Drug Resistance, Multiple ; Humans ; Infant ; Infant, Newborn ; Prevalence ; Respiratory Tract Infections ; microbiology ; Streptococcus pneumoniae ; drug effects ; isolation & purification