Prevalence of penicillin-nonsusceptible Streptococcus pneumoniae in nasopharyngeal cultures from patients with sickle cell disease

Background. Prevention of pneumococcal sepsis in children with sickle cell disease (SCD) is threatened by the emergence of penicillin-nonsusceptible p neumococci. Methods, In this study, nasopharyngeal colonization with Streptococcus pneu moniae and penicillin susceptibility were compared in children with SCD and a control group. Nasopharyngeal cultures were obtained from 130 children w ith SCD and 123 control children. Penicillin susceptibility was determined by Epsilometer test. Compliance with penicillin prophylaxis in SCD patients was determined by parent interviews and review of patients' medical and ph armacy records. Results. Streptococcus pneumoniae was isolated from 8 (6%) of 130 SCD patie nts, and 21 (17%) of 123 control patients. Of the 29 S pneumoniae isolates, 6 (21%) were nonsusceptible to penicillin; 3. of 8 (50%) were from the SCD group and 2 of 21 (10%) from the control group. Conclusions. Penicillin prophylaxis decreased the rate of S pneumoniae colo nization in SCD patients; however; it also increased the risk of selective colonization with penicillin-nonsusceptible S pneumoniae.