Increasing bacterial resistance in pediatric acute conjunctivitis (1997-1998)

We sought to determine the current level of resistance in Haemophilus influ enzae and Streptococcus pneumoniae, the primary pathogens of pediatric conj unctivitis, Bem-een January 1997 and March 1998, we prospectively cultured acute conjunctivitis in 250 ambulatory pediatric patients from rural Kentuc ky whose a average age was 24.3 months. In those 250 cases, 106 H. influenz ae (42% of the total) and 75 S. pneumoniae (30% of the total) pathogens wer e isolated, with no growth or no pathogen resulting in 79 cases (32% of the total). Beta-lactamase was detected in 60 (69%) of 87 tested strains of H. influenzae, Among 65 isolates of S. pneumoniae tested for penicillin susce ptibility, 44 (68%) were susceptible, 17 (26%) were resistant, and 4 (6%) w ere intermediate. Conjunctivitis with acute otitis media was observed in 97 patients (39%), and H. influenzae was recovered in 57% of these 97 cases. As for in vitro activity, ciprofloxacin, ofloxacin, and tetracycline were t he most active; and gentamicin, tobramycin, polymyxin B-trimethoprim, and p olymyxin B-neomycin were intermediately active. Sulfamethoxazole possessed no activity against either pathogen. Beta-lactamase production was detected in 69% of H. influenzae strains, which still remains the primary causative pathogen of both conjunctivitis and conjunctivitis-otitis syndrome. Penici llin-nonsusceptible S, pneumoniae was observed in 32% of 65 patients with S . pneumoniae conjunctivitis, with most strains being penicillin resistant.