Carriage of antibiotic-resistant pneumococci among Asian children: A multinational surveillance by the Asian network for surveillance of resistant pathogens (ANSORP)

To investigate the nasal carriage of antibiotic-resistant pneumococci by ch ildren, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be non susceptible to penicillin. Prevalence of penicillin nonsusceptibility was h ighest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban a reas, enrollment in day care, and a history of otitis media. The most commo n serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common cl one, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resi stance among isolates of pneumococci carried nasally in children in Asia an d the Middle East and showed that this is due to the spread of a few predom inant clones in the region.