{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:00:55Z","timestamp":1793145655993,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T00:00:00Z","timestamp":1319673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Background and objective:\u2003<\/jats:bold>  <jats:italic>Streptococcus pneumoniae<\/jats:italic> is an important cause of morbidity and mortality in both the paediatric and adult population. This study aimed to define pneumococcal colonization rates, and antibiotic resistance patterns across two periods a decade apart, and also assess the serotypes of colonizing strains in children in the era of early pneumococcal conjugate vaccine uptake in Singapore.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> Two cross\u2010sectional prevalence surveys were carried out in 1997 and 2007\u20132008 on children attending day\u2010care centres across Singapore. Nasopharyngeal swabs were obtained and cultured for <jats:italic>S.\u2003pneumoniae<\/jats:italic>, and antibiotic susceptibility testing was performed. Serotyping was also done in the 2007\u20132008 survey.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> Three hundred and ninety\u2010five children participated in the first survey in 1997, and 418 in the 2007\u20132008 survey. Pneumococcal colonization rates were 25.8 and 14.1%, respectively. There was a marked increase in antimicrobial non\u2010susceptibility (penicillin 27.4% vs 69.5%; erythromycin 33.4% vs 78%; clindamycin 24.5% vs 45.8%, tetracycline 48% vs 67.8%), and multi\u2010drug resistance (defined as non\u2010susceptibility to three or more classes of antibiotics) increased from 33.3 to 74.6%. In the 2007\u20132008 survey, serotypes 6B (16.9%), 23F (11.9%) and 19F (10.2%) were most commonly observed. The projected coverage of the 7 and 13\u2010valent conjugate pneumococcal vaccine for colonizing serotypes were 61.9 and 67%, respectively.<\/jats:p><jats:p><jats:bold>Conclusions:\u2003<\/jats:bold>  <jats:italic>S.\u2003pneumoniae<\/jats:italic> antibiotic resistance has risen dramatically over the last 10\u2003years in Singapore. Wider conjugate vaccine uptake and improved antibiotic stewardship should be made priorities. Surveillance of sentinel sites like day\u2010care centres provides important data with respect to shifts in pneumococcal ecology.<\/jats:p>","DOI":"10.1111\/j.1440-1843.2011.02036.x","type":"journal-article","created":{"date-parts":[[2011,8,17]],"date-time":"2011-08-17T12:56:42Z","timestamp":1313585802000},"page":"1241-1248","source":"Crossref","is-referenced-by-count":20,"title":["Increasing antibiotic resistance in <i>Streptococcus pneumoniae<\/i> colonizing children attending day\u2010care centres in Singapore"],"prefix":"10.1111","volume":"16","author":[{"given":"SHAWN","family":"VASOO","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KAMALJIT","family":"SINGH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LI YANG","family":"HSU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YOKE FONG","family":"CHIEW","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CAROL","family":"CHOW","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RAYMOND T.P.","family":"LIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PAUL A.","family":"TAMBYAH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,27]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(67)92346-X"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)92892-6"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.6.2101-2107.2004"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.04.035"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022823"},{"key":"e_1_2_7_7_2","first-page":"893","article-title":"Direct and indirect effects of routine vaccination of children with 7\u2010valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease\u2014United Centers for Disease Control and Prevention (CDC). 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