Please use this identifier to cite or link to this item: https://doi.org/10.1111/j.1440-1843.2011.02036.x
Title: Increasing antibiotic resistance in Streptococcus pneumoniae colonizing children attending day-care centres in Singapore
Authors: Vasoo, S.
Singh, K.
Hsu, L.Y. 
Chiew, Y.F.
Chow, C.
Lin, R.T.P. 
Tambyah, P.A. 
Keywords: antimicrobial resistance
colonization
day-care centre
S. pneumoniae
serotype
Issue Date: Nov-2011
Source: Vasoo, S., Singh, K., Hsu, L.Y., Chiew, Y.F., Chow, C., Lin, R.T.P., Tambyah, P.A. (2011-11). Increasing antibiotic resistance in Streptococcus pneumoniae colonizing children attending day-care centres in Singapore. Respirology 16 (8) : 1241-1248. ScholarBank@NUS Repository. https://doi.org/10.1111/j.1440-1843.2011.02036.x
Abstract: Background and objective: Streptococcus pneumoniae is an important cause of morbidity and mortality in both the paediatric and adult population. This study aimed to define pneumococcal colonization rates, and antibiotic resistance patterns across two periods a decade apart, and also assess the serotypes of colonizing strains in children in the era of early pneumococcal conjugate vaccine uptake in Singapore. Methods: Two cross-sectional prevalence surveys were carried out in 1997 and 2007-2008 on children attending day-care centres across Singapore. Nasopharyngeal swabs were obtained and cultured for S. pneumoniae, and antibiotic susceptibility testing was performed. Serotyping was also done in the 2007-2008 survey. Results: Three hundred and ninety-five children participated in the first survey in 1997, and 418 in the 2007-2008 survey. Pneumococcal colonization rates were 25.8 and 14.1%, respectively. There was a marked increase in antimicrobial non-susceptibility (penicillin 27.4% vs 69.5%; erythromycin 33.4% vs 78%; clindamycin 24.5% vs 45.8%, tetracycline 48% vs 67.8%), and multi-drug resistance (defined as non-susceptibility to three or more classes of antibiotics) increased from 33.3 to 74.6%. In the 2007-2008 survey, serotypes 6B (16.9%), 23F (11.9%) and 19F (10.2%) were most commonly observed. The projected coverage of the 7 and 13-valent conjugate pneumococcal vaccine for colonizing serotypes were 61.9 and 67%, respectively. Conclusions: S. pneumoniae antibiotic resistance has risen dramatically over the last 10 years in Singapore. Wider conjugate vaccine uptake and improved antibiotic stewardship should be made priorities. Surveillance of sentinel sites like day-care centres provides important data with respect to shifts in pneumococcal ecology. Resistance in colonizing isolates of Streptococcus pneumoniae rose dramatically over two surveys a decade apart. High-dose penicillin rather than macrolides were found to be more appropriate for treatment of pneumococcal disease. Surveillance of sentinel sites like day-care centres provides useful data on changing pneumococcal ecology in the era of conjugate vaccination. © 2011 Asian Pacific Society of Respirology.
Source Title: Respirology
URI: http://scholarbank.nus.edu.sg/handle/10635/127123
ISSN: 13237799
DOI: 10.1111/j.1440-1843.2011.02036.x
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