ACQUISITION, CARRIAGE, AND TRANSMISSION OF PNEUMOCOCCI WITH DECREASEDANTIBIOTIC SUSCEPTIBILITY IN YOUNG-CHILDREN ATTENDING A DAY-CARE FACILITY IN SOUTHERN ISRAEL

The prevalence and transmission of antimicrobial drug-resistant pneumo cocci was studied in 48 children attending a day care facility in sout hern Israel. Nasopharyngeal cultures were obtained every 2 weeks for 1 0 months, and antibiotic susceptibility of isolates was determined by disk diffusion and E-test, Relatedness of isolates was investigated by capsular typing, ribotyping, and arbitrarily primed polymerase chain reaction. Pneumococci were recovered during 362 (63%) of 573 fortnight s, and 219 (60%) of these isolates showed decreased susceptibility to at least one drug; 154 (43%) were intermediately susceptible to penici llin and 51 (14%) were multiresistant. Combining the different typing methods showed that a Limited number of clones circulated in the facil ity. Clones exhibiting decreased antibiotic susceptibility (especially 23F, intermediately susceptible to penicillin and resistant to trimet hoprim-sulfamethoxazole, and multiresistant 6B) were more frequently i solated and persisted longer than did fully susceptible clones. By mul tivariate analysis, carriage of organisms with decreased antibiotic su sceptibility was associated with young age, female sex, winter season, and exposure to antimicrobial drugs during the previous month.