Programme no. 443-OP
Prevalence of resistant bacteria in children in primary care.
1Institutionen för kliniska vetenskaper, Lunds universitet,Malmö,Sweden
* = Presenting author
Objectives: This study aim to provide information about the current prevalence of PNSP in children at a primary care level and if possible identify association to antibiotic use.
Background: About 30 % of the visits to primary healthcare in Sweden concerns infectious problems, of these some 70% regards respiratory tract symptoms. Children at the age of 0-6 years recieve most antibiotic of all age groups and infecions in the upper airways dominate the diagnosis. The frequency of pneumococci with reduced susceptability to penicillin (PNSP) in children was found to be high in the early 90’s in Sweden. The frequency of PNSP was found to be correlated to the antibiotic consumption. In Sweden antibiotic prescribing to children has been substantially reduced over the last decades.
The collection of nasopharyngeal cultures are ongoing at the moment, so far 226 cultures have been analyzed. The current findings suggests that PNSP (MIC=0,125 mg/l) are very sparse at a rate of 6 %. No resistant pneumococci (MIC>1.0 mg/l) has been registered so far. The Betalactamasproduction in Hemophilus Influenzae has been found to be 30 % and in Moraxella Catarrhalis is 98%.
The process of gathering samples will be ongoing until spring 2015.
Nasopharyngeal cultures will be performed on children, aged 0-10 years of age, consulting their medical center with symptoms of respiratory tract infection (RTI). The parents will be asked to fill out a questionnaire about the child’s antibiotic consumption and other questions of concern. Isolates of Streptococcus pneumoniae, Hemofilus Influenzae, Moraxella catarrhalis and Group A Streptococci will be noted. Pneumococci with a minimal inhibitory concentration (MIC) exceeding 1.0 mg/l will be regarded as resistant. Frequency of Betalactamase production in Hemophilus Influenzae and Moraxella Catarrhalis will be registered.
Conclusion: Despite a decrease in antibiotic prescribing to children, there seem to be an increase in resistant markers such as betalactamase production in Moraxella Catarrhalis and Hemophilus Influenzae. PNSP seem to be kept at a low level, compared to the outbreak in the early 90's.
Points for discussion:
Is there an association between the presence of resistant bacteria and previous antibiotic consumption, at an individual level?
How do we monitor bacterial resistance in primary care?