COLONIZATION BY STREPTOCOCCUS-PNEUMONIAE AMONG HUMAN IMMUNODEFICIENCYVIRUS-INFECTED ADULTS - PREVALENCE OF ANTIBIOTIC-RESISTANCE, IMPACT OF IMMUNIZATION, AND CHARACTERIZATION BY POLYMERASE CHAIN-REACTION WITHBOX PRIMERS OF ISOLATES FROM PERSISTENT STREPTOCOCCUS-PNEUMONIAE CARRIERS

Pharyngeal colonization by Streptococcus pneumoniae was evaluated in 1 03 human immunodeficiency virus (HIV)-infected subjects (<200 CD4 cell s/mu L, 57; greater than or equal to 200 CD4 cells/mu L, 46) and 39 no n-HIV-infected controls who were participants in a vaccine study. At b aseline, 7%, 20%, and 10% of subjects in the <200 and greater than or equal to 200 CD4 cell groups and in the control group were colonized w ith S. pneumoniae: Rates at 6 months were 23%, 22%, and 0%, respective ly. Of 34 isolates from HIV-infected subjects, 25 were penicillin-resi stant and 19 were resistant to greater than or equal to 3 antimicrobia ls; of 8 isolates from controls, 1 was resistant, Resistance to trimet hoprim-sulfamethoxazole was significantly higher among HIV-infected su bjects with <200 CD4 cells/mu L than in those with more CD4 cells, Pol ymerase chain reaction DNA analysis with BOX primers demonstrated that 12 HIV-infected subjects were persistently colonized with the same S. pneumoniae strain for greater than or equal to 1 month compared with none of the controls. HIV-infected subjects were more likely to be per sistent pneumococcal carriers and to carry antibiotic-resistant isolat es than were non-HIV-infected subjects.