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Antimicrobial Susceptibilities and Serotype Distribution of Streptococcus pneumoniae Isolates from a Low Socioeconomic Area in Lima, Peru

Emory University Hospital,¹ Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia,⁴ Department of International Health, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland,² Asociación Benéfica Proyectos en Informática, Salud, Medicina, y Agricultura (AB PRISMA),³ Infectious Disease Laboratory, Department of Pathology,⁵ Department of Pathology, Universidad Peruana Cayetano Heredia,⁶ Hospital María Auxiliadora, Lima, Perú⁷

Received 29 April 2002/ Returned for modification 12 June 2002/ Accepted 22 July 2002

Streptococcus pneumoniae isolates were obtained from nasopharyngeal swabs taken from children living in a low socioeconomic area of Lima, Peru, to determine the rates of antimicrobial resistance and serotype distribution. A total of 146 nasopharyngeal isolates were collected from children from 3 to 38 months of age. Twenty-one clinical laboratory isolates from both sterile and nonsterile sites were obtained from a local hospital. Isolates with reduced susceptibilities to penicillin represented 15.1 and 42.9% of the nasopharyngeal and clinical isolates, respectively. For neither group of isolates did penicillin MICs exceed 1.5 µg/ml, indicating only intermediate resistance. Thirty-two different serotypes were identified from the 146 nasopharyngeal isolates. The serotypes of the clinical isolates were represented among those 32 types. Isolates with reduced susceptibility to multiple antimicrobial agents were present in both settings. These findings indicate some of the highest rates of antimicrobial resistance in the region as well as a slightly different serotype distribution pattern from those of other South American countries. The 7-valent conjugate pneumococcal vaccines would only have a limited effect, providing coverage for about half of all isolates. Increasing rates of resistance in Peru necessitate an awareness of antimicrobial treatment practices and vaccination strategies.