Spread of multidrug-resistant Streptococcus pneumoniae among hospitalized children in Slovakia.

A multidrug-resistant serotype 14 strain of Streptococcus pneumoniae was isolated from sterile-site specimens and nasopharyngeal secretions from > 200 children in Slovakia between 1985 and 1990. Nasopharyngeal culture surveys were done to determine the extent of spread and means of transmission of this strain. The resistant strain was isolated from cultures of 8 (33.0%) of 24 children at hospital A and from 1 (0.8%) of 130 children attending outpatient clinics or day care centers (P < .001). One-quarter of the initially uncolonized children at hospital A acquired the resistant strain during hospitalization. Among hospitalized children, frequent antimicrobial drug use (P < .01), prior hospitalization (P < .005), and length of hospital stay (P < .001) were associated with infection with the resistant strain. These findings support limiting broad-spectrum antimicrobial drug use and nonessential hospitalizations in settings were drug-resistant pneumococci are prevalent. Development of a pneumococcal vaccine that is immunogenic in young children is urgently needed.