Streptococcus pneumoniae antibiotic resistance in Northern Territory children in day care

Background: There is evidence that the rapid rise in Streptococcus pneumoni ae (SP) antimicrobial resistance seen in other countries may have commenced in Australia. Streptococcus pneumoniae carriage and resistance levels are described for urban Northern Territory children in day care. Methods: A prospective cohort study was conducted of 250 children in nine D arwin day care centres between 24 March and 15 September 1997. Each fortnig ht nasopharyngeal swabs were collected from children, and parents were inte rviewed about medications administered. Results: Streptococcus pneumoniae was detected in 52% (1028/1974) of all na sopharyngeal swabs. Streptococcus pneumoniae was isolated from 92% (231/250 ) of children at some time. Penicillin resistance was found in 30% (312/102 8) of isolates using a screening test. Of these, 256 (82%) had resistance c onfirmed by E-test. Two hundred and one (20% of all isolates) had intermedi ate penicillin resistance and 55 (5% of all isolates) had high revel resist ance. Ceftriaxone resistance was found in 19% of children's first isolates. Resistance to other antibiotics was also common: co-trimoxazole 45%, eryth romycin 17%, tetracycline 17% and chloramphenicol 13%. A total of 17% (172/ 1028) of the isolates were multiresistant. The average fortnightly proporti on of children given antibiotics was 16% (405/2476). Conclusions: Levels of intermediate and high level penicillin resistance in this day care population are consistent with previous data from the Northe rn Territory, and considerably higher than the rest or Australia. The natio nal trend of increasing pencillin resistance is likely to continue.