{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T08:00:55Z","timestamp":1772697655991,"version":"3.50.1"},"reference-count":31,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2001,10,1]],"date-time":"2001-10-01T00:00:00Z","timestamp":1001894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2001,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Resistance to penicillin and multiple antimicrobial agents among\n            <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n            strains is becoming an increasing problem worldwide and in Asia. To determine the prevalence of carriage of\n            <jats:italic>S. pneumoniae<\/jats:italic>\n            isolates not susceptible to penicillin in young children, we obtained nasopharyngeal swab specimens from 1,978 children (ages, 2 to 6 years) attending 79 day care centers or kindergartens. Three hundred eighty-three strains of\n            <jats:italic>S. pneumoniae<\/jats:italic>\n            were isolated from these children. Fifty-eight percent of these isolates had reduced susceptibility to penicillin, 123 (32.1%) were intermediate, and 100 (26.1%) were resistant. A very high penicillin MIC (4 \u03bcg\/ml) was found in 3.3% of the isolates. The isolates also demonstrated high rates of resistance to other antimicrobial agents (51.2% to cefaclor, 50.2% to cefuroxime, 42.8% to cefotaxime, 80.7% to trimethoprim-sulfamethoxazole, 77% to erythromycin, 60% to clindamycin, and 33.7% to chloramphenicol). No isolate was resistant to fluoroquinolone. Multidrug resistance (not susceptible to the \u03b2-lactams and three or more other classes) was found in 39.4% of the isolates. Risk factors for the carriage of\n            <jats:italic>S. pneumoniae<\/jats:italic>\n            not susceptible to penicillin were multiple physician visits in the preceding 3 months and use of antimicrobial agents by the individual or by household members in the preceding 3 months. In the logistic regression analysis, only the use of antimicrobial agents in the preceding 3 months was an independent risk factor (\n            <jats:italic>P<\/jats:italic>\n            = 0.004; odds ratio, 2; 95% confidence interval, 1.2 to 3.2). This study demonstrated the high prevalence of antibiotic-resistant\n            <jats:italic>S. pneumoniae<\/jats:italic>\n            in healthy young children in the community in Hong Kong.\n          <\/jats:p>","DOI":"10.1128\/aac.45.10.2765-2770.2001","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:06:42Z","timestamp":1027764402000},"page":"2765-2770","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":46,"title":["Nasopharyngeal Carriage of Antimicrobial-Resistant\n            <i>Streptococcus pneumoniae<\/i>\n            among Young Children Attending 79 Kindergartens and Day Care Centers in Hong Kong"],"prefix":"10.1128","volume":"45","author":[{"given":"Susan S.","family":"Chiu","sequence":"first","affiliation":[{"name":"<!--label omitted: 1-->Department of Pediatrics1 and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pak Leung","family":"Ho","sequence":"additional","affiliation":[{"name":"<!--label omitted: 2-->Department of Microbiology,2 University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frankie K. H.","family":"Chow","sequence":"additional","affiliation":[{"name":"<!--label omitted: 2-->Department of Microbiology,2 University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwok Yung","family":"Yuen","sequence":"additional","affiliation":[{"name":"<!--label omitted: 2-->Department of Microbiology,2 University of Hong Kong, Hong Kong, Special Administrative Region, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu Lung","family":"Lau","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Department of Pediatrics1 and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.362"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/15.1.77"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)70326-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510470035031"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/13.3.229"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.36.7.1933-1937.1998"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199910000-00006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0691.2000.00063.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/22.6.966"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/313465"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.5.1310"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(95)90209-0"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/320181"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.153.5.495"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199804000-00004"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s100960050399"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(96)00156-9"},{"key":"e_1_3_2_19_2","first-page":"357","article-title":"Antibiotics and upper respiratory infection: do some folks think there is a cure for the common cold.","volume":"42","author":"Mainous A. G.","year":"1996","unstructured":"Mainous A. G. Hueston W. J. Clark J. R. Antibiotics and upper respiratory infection: do some folks think there is a cure for the common cold. J. Fam. Pract. 42 1996 357 361","journal-title":"J. Fam. Pract."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s100960050202"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/24.3.441"},{"key":"e_1_3_2_22_2","unstructured":"National Committee for Clinical Laboratory Standards\n          Performance standards for antimicrobial susceptibility testing 9th informational supplement. M100\u2013S9.\n          1999\n          National Committee for Clinical Laboratory Standards\n          Wayne Pa"},{"key":"e_1_3_2_23_2","unstructured":"National Committee for Clinical Laboratory Standards\n          Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. 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