Low rates of antimicrobial resistance in respiratory pathogens from a pediatric population in north-eastern Italy.

BACKGROUND: Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes are the main agents of bacterial upper respiratory tract infections in infants and children. In the past decades, the proportion of patients infected with drug-resistant organisms has increased; surveying at a regional level is important for understanding the size of the problem and elaborating therapeutic guidelines based on local epidemiology. METHODS: Since 1997, all isolates of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes have been surveyed for antimicrobial resistance. RESULTS: In our zone, we found 3.5% penicillin-resistant and 18% macrolide-resistant Streptococcus pneumoniae, 15.8% ampicillin-resistant Haemophilus influenzae and 24.8% erythromycin-resistant Streptococcus pyogenes. CONCLUSIONS: Penicillin-resistant Streptococcus pneumoniae (PRSP) in our area does not represent a real concern; conversely, macrolide resistance in Streptococcus pneumoniae is relatively frequent. Resistance to ampicillin in Haemophilus influenzae in our area seems relatively low, due to beta-lactamase production. Even for Streptococcus pyogenes, macrolide resistance rates in our region are relatively low if compared with other countries and other italian regions. In conclusion, in our area penicillins are still the first choice drugs, at least in noncomplicated or not recurrent infections.