HIGH PREVALENCE OF MULTIDRUG-RESISTANT STREPTOCOCCUS-PNEUMONIAE AMONGCHILDREN IN A RURAL KENTUCKY COMMUNITY

In 1992 drug-resistant Streptococcus pneumoniae was cultured with incr easing frequency from aspirates of middle ear fluid from children with acute otitis media in a rural Kentucky community. To determine the pr evalence of carriage of drug-resistant S. pneumoniae in the community, we obtained nasopharyngeal swabs from 158 (70%) of 227 children atten ding a child daycare center and from 82 children attending the county health center. S. pneumoniae was isolated from 126 children. Among 123 isolates tested 65 (53%) were penicillin-resistant, including 41 (33% ) strains that were highly resistant; 61 (50%) were multidrug-resistan t. Serotypes 19F, 6B, 23F and 6A comprised 89% of the penicillin-resis tant isolates. Detection of a variety of serotypes and drug resistance patterns among nasopharyngeal isolates of S. pneumoniae suggests that multidrug-resistant pneumococcal strains are endemic in this communit y. Surveillance for drug-resistant pneumococci with the use of respira tory secretions obtained by nasopharyngeal swab may provide useful inf ormation on the prevalence of drug-resistant strains causing invasive disease and otitis media. Such information could be used to guide empi ric therapy of pneumococcal infections.