Haemophilus influenzae type b carriage among 3- to 24-month-old Turkish children

There are few studies from developing countries on the epidemiology of Haemophilus influenzae (Hib) infections among infants and children. We set out to determine the prevalence of oropharyngeal Hib colonization among Turkish children younger than two years of age and to identify antimicrobial resistance among the isolates. A cross-sectional study was conducted on 818 healthy children and oropharyngeal secretions were sampled. The carriage rate of Hib was found to be 7.2% and this increased significantly with age. Carriage of Hib among 3- to 6-month-old children (3.5%) was higher than expected and was significantly higher among children who were passive smokers (P=0.04). Logistic regression analysis showed that breastfeeding status was the sole significant factor for colonization (OR 2.2, 95% CI 1.26-3.82). Antimicrobial susceptibility tests on 56 isolates of H. influenzae showed that 51.8% and 21.4% were resistant to trimethoprim-sulphamethoxazole and ampicillin respectively. Other notable resistances were to cefalexin (10.7%) and chloramphenicol (3.6%); no isolates were resistant to ceftriaxone.     

2008—2010年湖北省流感嗜血杆菌标本分布及耐药性分析

目的了解湖北省不同地区分离的流感嗜血杆菌的分布及其耐药性。方法收集2008-2010年湖北省15所三级甲等医院临床分离的流感嗜血杆菌,采用纸片扩散法进行药敏试验,按照美国临床实验室标准化研究所（CLSI） 2009版标准判断结果;采用头孢硝噻吩纸片法检测产β 内酰胺酶情况。结果共分离流感嗜血杆菌855株,主要分离自住院患者（673株,78.71%）;以呼吸道标本多见,占87.37%（747株）;成人分离575株（67.25%）,儿童分离280株（32.75%）,其中157株（56.07%）分离自2岁以下儿童。流感嗜血杆菌对复方磺胺甲口恶唑的耐药率最高,为58.0%,其他依次为氨苄西林42.9%、氯霉素16.9%、氨苄西林/舒巴坦16.2%,头孢呋辛、头孢噻肟、环丙沙星、左氧氟沙星和阿奇霉素的耐药率均＜10%。232株产β 内酰胺酶,产酶率为27.13%;产β 内酰胺酶率,成人分离株为22.26%,儿童分离株为37.14%。共分离32株β 内酰胺酶阴性氨苄西林耐药株（BLNAR）。结论湖北省分离的流感嗜血杆菌主要分离自住院患者、呼吸道标本;对复方磺胺甲口恶唑和氨苄西林耐药率较高;儿童组β 内酰胺酶检出率高于成人组。产β 内酰胺酶是流感嗜血杆菌对氨苄西林耐药的主要机制。     

成人呼吸道感染副流感嗜血杆菌生物学分型及耐药性

目的了解某院成人呼吸道感染副流感嗜血杆菌的生物型,以及其与产β 内酰胺酶及耐药性的关系。方法收集该院2011年10月-2012年7月临床确诊为呼吸道感染患者（成人）的痰标本1 994份,进行嗜血杆菌分离培养;对分离的副流感嗜血杆菌进行鉴定、生物学分型、β 内酰胺酶试验和药敏试验。结果1 994份痰标本共分离嗜血杆菌102株（5.12%）,其中副流感嗜血杆菌68株（66.67%）,流感嗜血杆菌20株（19.61%）,其他嗜血杆菌14株（13.72%）。副流感嗜血杆菌共检出Ⅰ～Ⅵ 6种生物型,分别为：Ⅰ型42株,Ⅴ型14株,Ⅱ、Ⅵ型各4株,Ⅲ、Ⅳ型各2株;其中54株（79.41%）产β 内酰胺酶。副流感嗜血杆菌对氨苄西林、左氧氟沙星、四环素和复方磺胺甲口恶唑呈现较高的耐药率,分别为83.82%、60.29%、57.35%和70.59%;对头孢噻肟、氨苄西林/舒巴坦、头孢克洛、克拉霉素、利福平的耐药率分别为8.82%、13.24%、5.89%、20.58%和25.00%;尚未检出对亚胺培南、氯霉素耐药的菌株。各生物型副流感嗜血杆菌对抗菌药物的耐药性存在一定差异。结论副流感嗜血杆菌是该院成人呼吸道感染的常见病原菌之一,Ⅰ型和Ⅴ型为主要流行生物型;多数菌株为产β 内酰胺酶株,临床应重视副流感嗜血杆菌生物学及耐药性分型监测,防止耐药菌株流行。     

Study of Haemophilus influenzae strains isolated at the Tunis children's hospital in the prevaccination era (1999-2002)

OBJECTIVE: This study had for aim to define the pattern of Haemophilus influenzae infections in a Tunisian hospital during the prevaccination era. We determined serotypes, biotypes, and antibiotic susceptibility of H. influenzae strains. DESIGN: 187 H. influenzae strains were identified in various samples between 1999 and 2002. RESULTS: Strains were isolated essentially from respiratory samples in 63.7% and cerebrospinal fluid in 21.4 %. The mean age of children with invasive infections was 16 months. All invasive strains belong to serotype b. Biotypes I, II and III were the most frequent (84.7%). Ampicillin resistance with betalactamase producing mechanism occurred in 26,7% of isolates, this type of resistance was more frequent among invasive strains (37.2%) than in non-invasive ones (22.8%). All betalactamase producing strains had amoxicillin MICs above 1 mg/l, these strains were susceptible to amoxicillin+clavulanate. Three strains were betalactamase negative ampicillin resistant with ampicillin MICs: 1.5, 3, and 4 mg/l. All strains were susceptible to cefotaxim with MICs < 0.19 mg/l. Antibiotic resistance concerned: chloramphenicol: 7.5%, tetracycline: 6.9% and trimethoprime-sulfamethoxazole: 13.9%. 8.1% of the strains were kanamicin resistant but concerned only betalactamase producing strains. CONCLUSION: Before the introduction of a conjugate vaccine, all invasive infections in young children were caused by H. influenzae b strains.     

The spectrum of infection and sensitivity of organisms isolated from African and Indian children in a Durban hospital

A prospective study was undertaken over a period of six months to determine the spectrum of infection, sensitivity of organisms isolated, and suitability of antibiotics chosen in 520 consecutive patients admitted to a paediatric unit. Culture and sensitivity of stool, urine and blood yielded 752 isolates; in 147 cases, more than one pathogen was isolated from the same or different sites. High rates of resistance to chloramphenicol, ampicillin, and kanamycin were seen in salmonellae other than Salmonella typhi, which differed in retaining its original sensitive susceptibility profile. Most Enterobacteria were sensitive to gentamicin. Penicillin-resistance was seen in 9% of meningococci, and several Haemophilus influenzae strains (20%) were resistant to ampicillin. Methicillin-resistance was encountered in 13% of Staphylococcus aureus strains and 17% of pneumococci were resistant to penicillin G. The sensitivity pattern of organisms isolated was probably directly related to widespread use of antibiotics.     

Nasopharyngeal carriage of community-acquired, antibiotic-resistant Streptococcus pneumoniae in a Zambian paediatric population.

The emergence of antibiotic-resistant Streptococcus pneumoniae is an international health problem. Apart from South Africa few data on pneumococcal resistance are available for sub-Saharan Africa. This study examines the nasopharyngeal carriage and prevalence of antibiotic resistance in pneumococci isolated from 260 Zambian children aged < 6 years. Pneumococci were isolated from 71.9% of the children; the odds of carrying organisms were twice as high among children < 2 years of age compared with older children. Antibacterial resistance was found in 34.1% of the isolates; resistance to tetracycline, penicillin, sulfamethoxazole + trimethoprim, and chloramphenicol occurred in 23.0%, 14.3%, 12.7%, and 3.9% of the isolates, respectively. Only 4% of the isolates were resistant to three drugs. High-level resistance was found in all isolates resistant to tetracycline; but only intermediate level penicillin resistance was found. A total of 11.1% of the isolates demonstrated intermediate resistance to sulfamethoxazole + trimethoprim. Children aged < 6 months were less likely to carry antibiotic-resistant organisms. Antibiotic resistance in S. pneumoniae appears to be an emerging public health problem in Zambia, and the national policy for the empirical treatment of pneumococcal meningitis and acute respiratory tract infections may need to be re-evaluated. The establishment of ongoing surveillance to monitor trends in pneumococcal resistance should be considered.     

某院流感嗜血杆菌耐药性及其对氨苄西林耐药机制

目的了解流感嗜血杆菌对常用抗菌药物的耐药性及其对氨苄西林的耐药机制。方法采用纸片扩散法和头孢硝噻吩纸片法,对2012年1月1日—12月31日某院住院及门诊患者送检标本分离的流感嗜血杆菌耐药性和β-内酰胺酶进行检测,聚合酶链反应(PCR)法对耐氨苄西林菌株进行TEM型和ROB型β-内酰胺酶基因扩增。结果 100例流感嗜血杆菌感染患者,年龄段分布主要为1~10岁,占61.00%。流感嗜血杆菌对氨苄西林耐药率为35.00%(35株),对复方磺胺甲口恶唑耐药率高,达64.65%;对左氧氟沙星和阿奇霉素敏感率最高,分别为97.96%、96.84%,对环丙沙星、头孢噻肟、氯霉素、头孢呋辛和氨苄西林/舒巴坦敏感率均较高,依次为96.91%、92.78%、85.71%、77.89%和74.75%。100株流感嗜血杆菌中,21株β-内酰胺酶阳性,且均为氨苄西林耐药株。对35株耐氨苄西林菌株进行TEM和ROB基因检测,结果 22株TEM型阳性,未检出ROB阳性株。结论流感嗜血杆菌对复方磺胺甲口恶唑敏感率低,对其他常用抗菌药物敏感率高;流感嗜血杆菌对氨苄西林的主要耐药机制为产TEM型β-内酰胺酶。     

某基层医院呼吸道感染者标本嗜血杆菌的分离与耐药情况

目的 了解某基层医院呼吸道感染患者嗜血杆菌的分离率、产酶率及耐药情况，以指导临床合理用药。方法对该院2005年8月-2007年9月收集的712份痰及咽拭子标本进行嗜血杆菌分离培养、鉴定，并以头孢硝噻吩纸片法进行伊内酰胺酶测定，采用K—B纸片扩散法进行药敏试验。结果共分离嗜血杆菌151株，其中流感嗜血杆菌43株（28．48％），副流感嗜血杆菌108株（71．52％）；检出β-内酰胺酶阳性菌株19株（12．58％），其中流感嗜血杆菌中检出6株（13．95％），副流感嗜血杆菌中检出13株（12．04％）。嗜血杆菌对氨苄西林、复方磺胺甲嚼唑、环丙沙星的耐药率分别为30．46％、77．48％、63．58％，对头孢呋辛、头孢噻肟耐药率仅为9．27％、5．96％。19株产酶菌对氨苄西林均耐药。结论该院呼吸道嗜血杆菌感染患者以感染副流感嗜血杆菌为主，临床治疗宜首选第二代与第三代头孢菌素及亚胺培南等药物。     

Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae in healthy children

An investigation was undertaken to determine the isolation rate and antibiotic resistance of Haemophilus influenzae from the nasopharynx of young children. The 996 subjects studied were up to 6 years of age. H. influenzae was isolated from 304 (30.5%) and strains of capsular type b from 11 (1.1%). Age, sibling status, season, respiratory infection and antibiotic therapy all influenced isolation rates. The overall prevalence of antibiotic resistance in the strains isolated was ampicillin 5.4% (all beta-lactamase producers), cefaclor 0.3%, chloramphenicol 1.3%, erythromycin 38.2%, tetracycline 1.3%, trimethoprim 5.4% and sulphamethoxazole 0%. Ampicillin resistance was more common in type b than non-capsulated strains.     

Impact of Streptococcus pneumoniae on pneumonia in Latin American children. SIREVA-Vigía Group]

Community-acquired pneumonia is one of the leading causes of infant morbidity and mortality. Studies conducted in developing countries indicate that the most serious symptoms of pneumonia are associated with bacterial causes, mainly Streptococcus pneumoniae, followed by Haemophilus influenzae type b. Managing those infections in children under two years of age is hindered by the lack of appropriate vaccines and by the decreased susceptibility of S. pneumoniae to penicillin and other antibiotics. In 1993, at the initiative of the Regional System for Vaccines of the Pan American Health Organization, and with funding from the Canadian International Development Agency, a study was designed to identify the S. pneumoniae capsular types that cause invasive disease in Latin American children under 5 years of age. The objective of the study was to determine the ideal composition of a conjugate vaccine that could be used in Latin America, and the penicillin susceptibility of the S. pneumoniae isolates. The initiative was undertaken in Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay. This report analyzes the information that the participating countries generated on pneumococcal pneumonia. A total of 3,393 children were found with systemic S. pneumoniae infections, of which 1,578 corresponded to pneumonias. The analysis focused on 1,409 cases of pneumonia in Argentina, Brazil, Colombia, Mexico, and Uruguay. Of the children, 63.8% of them were under two years of age. Twelve prevalent capsular types were identified, of which serotypes 14, 5, and 1 were the three most common in the majority of the countries. At the beginning of the study the highest level of penicillin resistance was found in Mexico (47.0%), and the lowest in Colombia (12.1%). Over the 1993-1998 period, resistance to penicillin increased in the five countries. Penicillin resistance was associated with a small number of capsular serotypes, mainly 14 and 23F. The first of those serotypes was resistant to penicillin and to trimethoprim-sulfamethoxazole, and the second was multiresistant. The frequency of resistance to trimethoprim-sulfamethoxazole was high in all of the countries; Argentina had the highest level, 58.0%. A decrease in susceptibility to chloramphenicol was uncommon, except in Colombia, where there was a resistance level of 23.4%. Resistance to erythromycin was low in all the countries, and all the isolates were susceptible to vancomycin.     

Monitoring antibiotic resistance in Argentina. The WHONET program, 1995-1996]

The World Health Organization has implemented a surveillance program for antimicrobial resistance that is known as WHONET. In Argentina the program was developed through a network of 23 public and private hospitals that participate in national and international quality-control programs. Between January 1995 and December 1996, the antimicrobial susceptibility of 16,073 consecutive clinical isolates was determined, using the recommended standards of the National Committee for Clinical Laboratory Standards of the United States of America. More than half of the Escherichia coli urinary isolates were resistant to ampicillin and more than 30% to trimethoprim/sulfamethoxazole (SXT). When the percentage of resistant isolates from outpatients (OPs) was compared to that observed in hospitalized patients (HPs), a marked difference in antimicrobial activity was noted in the case of gentamicin (2% from OPs resistant vs. 8% from HPs resistant), norfloxacin (2% vs. 6%), and third-generation cephalosporins (7% vs. 15%). Of the Klebsiella pneumoniae isolates recovered from blood cultures, 71% and 60% showed resistance to third-generation cephalosporins and to gentamicin, respectively. The overall rate of oxacillin resistance in Staphylococcus aureus was 39%. Around half of the Enterococcus spp. isolates showed high resistance to aminoglycosides, but resistance to glycopeptides was not found. In Argentina, ampicillin and SXT were not suitable for treating diarrhea. Shigella flexneri had a higher number of isolates resistant to both of those drugs (87% and 74%, respectively) than Sh. sonnei did (47% and 71%, respectively). About 40% of the Salmonella spp. isolated in pediatric hospitals were resistant to third-generation cephalosporins. When microorganisms causing bacterial meningitis were examined, Streptococcus pneumoniae showed a resistance rate of 18% to penicillin and Haemophilus influenzae a resistance rate of 19% to ampicillin. These rates are within the intermediate range reported for other countries of the Americas and for Europe.     

兰州地区呼吸道感染流感嗜血杆菌分布特点及耐药性分析

目的 分析近几年兰州地区呼吸道流感嗜血杆菌感染的人群和季节性分布特点及菌体耐药性.方法 收集2011-2013年兰州市第一人民医院住院急性呼吸道感染病人呼吸道标本,共检出流感嗜血杆菌312株.用K-B法检测药敏结果,头孢硝噻吩纸片检测β-内酰胺酶.将药敏结果用Whonet软件进行分析,得出各种药物流感嗜血杆菌耐药率.结果 流感嗜血杆菌的感染呈现以下特点：明显的季节性,流感嗜血杆菌感染主要集中在11月和12月,占全年感染数的50％以上,10岁以下儿童感染者98％集中在11月或12月;成年人感染流感嗜血杆菌,感染患者年龄50岁以上者占91.4％;细菌耐药性特点：65.4％的分离株产3-内酰胺酶、氨苄西林、氨苄西林/舒巴坦、头孢呋辛、头孢他啶、复方新罗明、氯霉素耐药率依次为66.3％叼1.0％、9.2％～22.8％、17.3％～20.1％、2.0％～4.4％、31.6％～51.7％、16.3％～18.4％,头孢曲松、头孢噻肟、亚胺培南和美罗培南尚未发现耐药株.结论 流感嗜血杆菌的感染呈明显的季节性分布,感染人群主要为婴幼儿及老年人,耐药率呈逐年上升趋势.     

慢性阻塞性肺疾病急性加重期患者下呼吸道感染病原体分布及耐药性

目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者下呼吸道感染病原体分布及耐药情况,为临床合理用药提供依据。方法对2011年1-12月入住某院呼吸科的200例AECOPD患者进行痰培养和药敏试验,采用WHONET5.3软件分析药敏结果。结果200例AECOPD患者,85例（42.50%）痰培养阳性,检出革兰阴性（G-）杆菌66株（77.65%）,革兰阳性（G+）球菌16株（18.82%）,真菌3株（3.53%）;居前6位的病原体分别为铜绿假单胞菌(36.47%)、肺炎克雷伯菌(11.76%)、流感嗜血杆菌(10.58%)、鲍曼不动杆菌(9.41%)、肺炎链球菌（9.41%）和金黄色葡萄球菌（8.24%）。铜绿假单胞菌对多种抗菌药物的耐药性较严重,其中对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢替坦、复方磺胺甲口恶唑、呋喃妥因的耐药率达100.00%,对头孢曲松的耐药率高达93.55%;鲍曼不动杆菌对氨苄西林、头孢唑林和呋喃妥因的耐药率＞75%;肺炎克雷伯菌对氨苄西林及呋喃妥因具有较高的耐药率（＞60%）;流感嗜血杆菌对氨苄西林和复方磺胺甲口恶唑的耐药率＞65%。7株金黄色葡萄球菌中,5株为耐甲氧西林株。结论AECOPD患者下呼吸道感染病原体以G-杆菌为主,且耐药较严重,治疗时应选择对G-杆菌敏感的抗菌药物,同时应警惕耐药的金黄色葡萄球菌及真菌感染。     

小儿下呼吸道疾病病原菌感染情况及对常用抗生素的敏感性

目的 探讨引起小儿呼吸道感染的病原菌分布情况及其对常用抗生素的耐药性.方法 回顾性分析因呼吸道感染性疾病在某院治疗的376例患儿临床资料,分析咽拭子的细菌培养鉴定及其耐药性.结果 ①376例标本中共分离出细菌和真菌125株,阳性检出率为33.2％.革兰阴性菌为89株,占总数的71.2％,包括为流感嗜血杆菌27株,大肠埃希菌24株,肺炎克雷伯杆菌17株,鲍氏不动杆菌14株,其他细菌7株;革兰阳性球菌为29株,占23.2％,包括肺炎链球菌12株,金黄色葡萄球菌10株,溶血葡萄球菌5株以及其他2株;真菌共检出7株,占5.6％,以白色念珠菌为主,共检出5株.②流感嗜血杆菌对左左氧氟沙星、阿米卡星的耐药率较低,对红霉素、庆大霉素、头孢噻肟等三代的耐药率较高,在40％～60％之间.大肠埃希菌和肺炎克雷伯杆菌均对亚胺培南及美罗培南的高度敏感,对氨苄西林等均不敏感.③肺炎链球菌对呋喃妥因部分抗生素较敏感,对青霉素G,红霉素、克林霉素、磺胺甲噁唑/甲氧苄啶及四环素高度耐药.金黄色葡萄球菌及溶血葡萄球菌对呋喃妥因、万古霉素、利福平较为敏感,对左氧氟沙星、庆大霉素、红霉素等均呈现不同程度的耐药,尤其对青霉素G100％耐药.结论 临床治疗应根据致病菌耐药的情况,兼顾不同患儿的特殊情况和个体差异,提高治疗效果、尽量降低多重耐药的发生和减少医疗费用.     

某儿童医院肺炎链球菌耐药性分析

目的了解某儿童医院肺炎链球菌对常用抗菌药物的耐药情况，以指导临床合理用药。方法对2000—2001年在该院就诊的上呼吸道感染患儿的鼻咽分泌物进行细菌培养；采用K-B纸片及E-test法对分离株进行药物敏感试验。结果分离出肺炎链球菌157株。肺炎链球菌对青霉素的耐药率为59．87％，对头孢呋辛、头孢克洛、红霉素、四环素的耐药率分别为40．77％，56．00％，77．71％，87．90％；对氯霉素仍保持低水平耐药(33．12％)，对阿莫西林／克拉维酸、头孢曲松有很好的敏感性。结论儿童上呼吸道感染的肺炎链球菌耐药形势严峻。     

Susceptibility to antimicrobial agents in isolates from invasive Streptococcus pneumoniae in Colombia]

A study was done to determine the patterns of susceptibility to antimicrobial agents in isolates of Streptococcus pneumoniae that caused invasive disease diagnosed in children under the age of 5 in Colombia between 1994 and 1996, as well as to establish the distribution of the capsular types of the resistant isolates. The analysis was done using 324 isolates obtained during the performance of the National Serotyping Protocol for S. pneumoniae carried out in Bogotá, Medellín, and Cali, Colombia, between July 1994 and March 1996. Of the 324 isolates, 119 (36.7%) showed diminished susceptibility to at least one antimicrobial agent, including 39 (12%) that showed diminished susceptibility to penicillin. Of these 39 resistant to penicillin, 29 showed intermediate resistance and 10 showed high resistance. Nine isolates (2.8%) showed resistance to ceftriaxone, 80 (24.7%) to the combination of trimethoprim and sulfamethoxazole (TMS), 49 (15.1%) to chloramphenicol, and 31 (9.6%) to erythromycin. Resistance to two antimicrobial agents was observed in 31 isolates (9.6%); multiple resistance was found in 22 (6.7%). These 22 multiresistant isolates all showed resistance to TMS. The most frequent associations were penicillin, TMS, and erythromycin (5 cases); penicillin, chloramphenicol, TMS, and erythromycin (4 cases); penicillin, ceftriaxone, chloramphenicol, and TMS (3 cases); and penicillin, ceftriaxone, chloramphenicol, TMS, and erythromycin (3 cases). The most frequent serotypes in the penicillin-resistant isolates were: 23F (53.8%), 14 (25.6%), 6B (7.7%), 9V (5.1%), 19F (5.1%), and 34 (2.6%). The most frequent serotypes in the isolates resistant to antimicrobial agents other than penicillin were: 5 (37.5%), 23F (7.5%), 14 (18.8%), and 6B (13.8%). This difference in the distribution of the serotypes was statistically significant (P < 0.0001). The study results indicate the need to maintain active surveillance of antibiotic susceptibility patterns in order to avoid resistance in S. pneumoniae and to provide timely information to change practices regarding prescribing and consuming antimicrobial agents.     

68株急性肾小球肾炎暴发相关A组链球菌耐药性分析

目的对贵州两县急性肾小球肾炎暴发相关A组链球菌（group A streptococcus，GAS）进行抗生素耐药性分析，探讨耐药监测在GAS疫情处理与控制中的作用。方法采用E—test法测定GAS对8种抗生素（氨苄青霉素、头孢曲松、万古霉素、红霉素、四环素、左氧氟沙星、氯霉素、克林霉素）的敏感性。结果68株GAS对红霉素和四环素的耐药率分别为88．2％和97．1％。不同人群、不同学校来源菌株对抗生素的敏感性无统计学差异（P〉0．05）。结论健康携带者与患者分离菌株间抗生素耐药性的一致性提示对自然人携带GAS的耐药监测对疾病控制与疫情处理的重要性；当地治疗GAS感染不宜使用红霉素，青霉素仍为治疗GAS感染的首选药物，对青霉素过敏者可选头孢菌素类抗生素替代。     

Characteristics of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus isolated from the nasopharynx of healthy children attending day-care centres in the Czech Republic

Nasopharyngeal carriage of potential pathogens was studied in 425 healthy 3- to 6-year-old children attending 16 day-care centres (DCCs) in nine Czech cities during the winter 2004-2005. The overall carriage of pathogens was 62.8% (Streptococcus pneumoniae, 38.1%; Haemophilus influenzae, 24.9%; Moraxella catarrhalis, 22.1%; Staphylococcus aureus, 16%). An age-related downward trend was observed for colonization with respiratory pathogens in contrast to Staph. aureus whose carriage was significantly higher among older children. The following serotypes of colonizing S. pneumoniae were the most predominant: 23F (20.6%), 6A (15.1%), 6B (12.7%), 18C (7.8%), 15B and 19F (6% each). The majority (94.3%) of H. influenzae isolates were non-typable; among capsulated isolates, serotype b was not found. Decreased susceptibility to penicillin was determined in 3% of pneumococci; 4.6% of H. influenzae strains and 85.1% of M. catarrhalis strains produced beta-lactamase. As for non-beta-lactam antibiotics, pneumococci resistant to trimethoprim-sulphamethoxazole were the most common (15.7%) among the attendees.     

Antibiotic resistance of retail food and human Campylobacter isolates on the island of Ireland from 2001-2002

The antimicrobial resistance profiles of Campylobacter isolates recovered from a range of retail food samples (n=374) and humans (n=314) to eight antimicrobial compounds were investigated. High levels of resistance in food C. jejuni isolates were observed for ceftiofur (58%), ampicillin (25%) and nalidixic acid (17%) with lower levels observed for streptomycin (7.9%) and chloramphenicol (8.3%). A total of 80% of human C. jejuni isolates were resistant to ceftiofur, while 17% showed resistance to ampicillin and nalidixic acid, 8.6% to streptomycin and 4.1% to chloramphenicol. Resistance to clinically relevant antimicrobials such as erythromycin, ciprofloxacin and tetracycline was 6.7, 12, and 15% respectively for all food isolates and was similar to corresponding resistance prevalences observed for human isolates, where 6.4, 12 and 13% respectively were found to be resistant. Comparisons of C. jejuni isolates in each location showed a high degree of similarity although some regional variations did exist. Comparison of total C. jejuni and C. coli populations showed minor differences, with C. jejuni isolates more resistant to ampicillin and ceftiofur. Multidrug resistance patterns showed some profiles common to human and clinical isolates.     

Occurrence of multiple antibiotic resistance and R plasmids in Enterobacteriaceae isolated from children in the Sudan

The prevalence of resistance to six commonly-used antimicrobial agents in faecal coliforms from children in Khartoum, Sudan was studied. A relatively high prevalence of resistance was found, ranging from 96% of children with isolates resistant to ampicillin to 70% of children with isolates resistant to chloramphenicol. Seventy-seven percent of children had isolates with high-level resistance to trimethoprim (MIC greater than 1000 micrograms/ml). Twenty-nine different resistance patterns were found. Thirty-nine percent of the children had isolates resistant to all six antibiotics studied, and 80% of children had isolates resistant to at least four. Transfer of resistance to each of the antimicrobials, in varying combinations, was demonstrated, but did not occur for all resistance patterns. Plasmid analysis showed plasmids ranging from 160 MDa to 2.8 MDa and isolates contained from one to five plasmids of different sizes. There were no consistent relationships between resistance pattern and plasmid profile, but multiple resistance transfer was mediated commonly by plasmids with a molecular weight of 62 MDa. The high prevalence of potentially transferable antibiotic resistance in gut commensals of children in the Sudan may be of importance in the management of enteric and other infections requiring antimicrobial treatment.