Nationwide Surveillance of Nasopharyngeal Streptococcus pneumoniae Isolates from Children with Respiratory Infection, Switzerland, 19981999

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http://www.journals.uchicago.edu/JID/journal/issues/v187n4/020970/brief/020970.abstract.html

The Journal of Infectious Diseases    2003;187:589-596
© 2003 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2003/18704-0008$15.00

 

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MAJOR ARTICLE

Nationwide Surveillance of Nasopharyngeal Streptococcus pneumoniae Isolates from Children with Respiratory Infection, Switzerland, 1998–1999

Kathrin Mühlemann,1 Hans C. Matter,2 Martin G. Täuber,1 and Thomas Bodmer,1 for the Sentinel Working Group

1Institute for Infectious Diseases, University Hospital, University of Bern, and 2Swiss Federal Office of Public Health, Bern, Switzerland

 

Received 14 August 2002; revised 24 October 2002; electronically published 29 January 2003.

The surveillance of pneumococcal antibiotic resistance and serotype distribution is hampered by the relatively low numbers of invasive pneumococcal infections. In Switzerland, a nationwide sentinel surveillance network was used to assess antibiotic resistance and serotype distribution among 1179 pneumococcal isolates cultured from 2769 nasopharyngeal swabs obtained from outpatients with acute otitis media or pneumonia during 1998 and 1999. The proportion of penicillin-susceptible pneumococcal isolates overall (87%) and among infants <2 years old (81%) was comparable to that of invasive isolates (90% and 81%, respectively). The high number of nasopharyngeal isolates allowed for the detection of a rapid increase in the number of penicillin-nonsusceptible pneumococcal (PNSP) strains in the West region of Switzerland, partly because of an epidemic caused by the 19F clone of Streptococcus pneumoniae. Clustering of risk factors for the carriage of PNSP isolates further explained the geographic variation in resistance rates. The nationwide sentinel surveillance of nasopharyngeal pneumococcus proved to be valuable for the monitoring of antibiotic resistance, risk factors for carriage of PNSP isolates, and serotype distribution and for the detection of the emergence of a new epidemic clone.

 

     Presented in part: 39th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, 26–29 September 1999 (abstract 1042); 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, 16–20 September 2000 (abstract 18093).
     This study was performed according to the guidelines on conduct of clinical research of the ethical committee of the State of Bern. Informed consent was obtained from the children's parents by physicians in the Sentinel Working Group.
     Financial support: Swiss National Science Foundation (grant 3100-052955.97/1 to K.M.); Bayer; Bristol Mayers; GlaxoSmithKline; Grünenthal; Lilly; Pfizer.
     No author has a commercial or other association that might pose a conflict of interest.

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