Antimicrobial resistance and serotype distribution of Streptococcus pneumoniae strains causing childhood infections in Bangladesh, 1993 to 1997

Three hundred sixty-two Streptococcus pneumoniae strains were isolated from children under 5 Scars of age at Dhaka Shishu (Children) Hospital from 199 3 to 1997, The strains were isolated from blood (n = 105), CSF (n = 163), e ar swab (n = 61), eye swab (n = 20), and pus (n = 12), Of the 362 isolates, 12 (11.6%) showed intermediate resistance (MIC, <0.1 mu g/ml) and only 4 ( 1.1%) showed complete resistance (MIC, >2.0 mu g/ml) to penicillin. Penicil lin resistance exhibited a strong relationship with serotype IJ; 47.8% of t he penicillin-resistant strains belonged to this type. A remarkably high (6 4.1%) resistance to co-trimoxazole was observed, along with a significant i ncrease during the time period studied; there was no relationship to capsul ar type. By way of contrast, penicillin resistance did not show any signifi cant change during the study period. Resistance to chloramphenicol (2.2%) a nd erythromycin (1.1%) was rare. The high resistance to co-trimoxazole and its increasing trend demand elucidation of the clinical impact of pneumonia treatment by this antimicrobial and reconsideration of the World Health Or ganization recommendation for co-trimoxazole administration to children wit h community-acquired pneumonia at the health care worker level in Banglades h.