Antibiotic Resistance Patterns and Risk Factors of Streptococcus Pneumoniae Carriage among Healthy Jordanian Children

Objectives: Isolation of Streptococcus pneumoniae from healthy children in Amman, Jordan. Methods: Nasal swabs were taken from 1002 healthy children. Isolates were analysed for antimicrobial susceptibility, serotypes, macrolide resistance genotypes and phenotypes. Results: The overall carriage rate was 19.5% (n= 195 isolates). The percentage of resistance was as follows: penicillin (91.8%), cefotaxime (29.2%), trimethoprim-sulfamethoxazole (66.7%), erythromycin (46.7%), clindamycin (19.5%), tetracycline (32.3%), chloramphenicole (6.2%) and ciprofloxacin (6.2%). 67 isolates (34.4%) were multi drug-resistant. MIC50 and MIC90 were as follows (μg/ml): Penicillin (1, 4), cefotaxime (1, 4), erythromycin (0.5, 32), and clindamycin (0.125, 32). PCR-based serotyping of the serotypes included in the 7v-PCV showed the following percentages: 19F (11.8%), 23F (9.7%), 9V (7.6%), 6B (6.7%), 14 (5.6%), 18C (4.6%) and 4 (2.6%). Among macrolide resistant isolates (n= 91), erm(B) was detected in 20.9% (n= 19), mef(A) in 53.8% (n= 49), both erm(B) and mef(A) 16.5% (n= 15) and 8.8% (n= 8) were negative for both determinants. Among the macrolide resistant isolates MLSBand M-phenotypes were 41.8% and 58.2%, respectively. Conclusions: The overall carriage rate of pneumococci in Jordan is low, but the level of antibiotic resistance is high. The spread of pneumococcal multi-drug resistance is worrisome. European International Journal of Science and Technology ISSN: 2304-9693 www.eijst.org.uk 56 Summary A total of 1002 children aged 2 to 6 years from kindergartens and pediatric clinics were subjected to nasopharyngeal swabs for the recovery of Streptococcus pneumoniae as potential infectious agent in the years 2005-2006 in Amman, Jordan. The overall carriage rate was 19.5% (n= 195 isolates). The percentage of resistance was as follows: penicillin (91.8%), cefotaxime (29.2%), trimethoprim-sulfamethoxazole (66.7%), erythromycin (46.7%), clindamycin (19.5%), tetracycline (32.3%), chloramphenicole (6.2%) and ciprofloxacin (6.2%). MIC50 and MIC90 for antibiotics were as follows (μg/ml): penicillin (1, 4), cefotaxime (1, 4), erythromycin (0.5, 32), and clindamycin (0.125, 32). 67 isolates (34.4%) were multi drug-resistant. PCR-based serotyping of the serotypes included in the 7v-PCV showed the following percentage of serotypes: 19F (11.8%), 23F (9.7%), 9V (7.6%), 6B (6.7%), 14 (5.6%), 18C (4.6%) and 4 (2.6%). Only two macrolide resistant phenotypes were detected: MLSB (41.8%) and M (58.2%). Among macrolide resistant isolates (n= 91), erm(B) was detected in 20.9% (n= 19), mef(A) in 53.8% (n= 49), both erm(B) and mef(A) 16.5% (n= 15) and 8.8% (n= 8) were negative for both determinants.