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To determine normal proportions of pharyngeal H. influenzae and H. parainfluenzae, qualitative and quantitative mapping of the species in the pharynx of 538 healthy children was carried out. The detection rates of H. influenzae rose to a peak at 4, 5 years, with a slow decline thereafter. In contrast to H. influenzae, the detection rates of H. parainfluenzae rose as the child became older in age. The rates of H. influenzae and H. parainfluenzae of the total cultivable flora showed the same tendency as the detection rates. No consistent seasonal fluctuations was found with H. influenzae. The pharyngeal swab was inferior to the nasopharyngeal swab in each age group, for detecting the carriage of H. influenzae and H. parainfluenzae in the upper respiratory tract. The rate of ampicillin-resistant H. influenzae was 17.7% in the nasopharynx.
Eighty-seven oropharyngeal isolates of Haemophilus influenzae were obtained by two time cultures six months apart from a total of 288 children who attend a kindergarten. We analyzed the strains by comparing their serotypes, biotypes, beta-lactamase activity and by performing electrophoresis of outer membrane proteins on polyacrylamide gels. Only nineteen strains were not identical, the rest of the 68 strains were classified into 23 types. During 6 months at least 15 types of strains lost from this group and 21 types of new strains were obtained. There were no children who had identical pairs of H. influenzae in their oropharynx during the 6 months. The classification of strains in oropharynx suggested that person-to-person transmission of nontypable H. influenzae can occur. We concluded that oropharyngeal colonization by nontypable H. influenzae is not a normal flora in children.
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The minimal inhibitory concentrations of rosamicin and erythromycin were compared for 210 strains of group A streptococcus isolated from a diverse spectrum of streptococcal diseases. Of these strains, 97.6% were inhibited by 0.1 to 0.2 mug of rosamicin per ml, whereas 90.9% were inhibited by 0.025 to 0.05 mug of erythromycin per ml. The minimal inhibitory concentration of rosamicin for 154 strains exceeded that of erythromycin by at least fourfold. Five group A strains of streptococcus that were highly resistant to erythromycin were even more resistant to rosamicin.
Of 500 group A streptococci isolated from pharyngeal swabs, 72 (14.4%) were macrolide resistant, compared to 2.1% in 1997. Of these, 66 (92%) were of the M phenotype and 6 (8.3%) were of the MLS phenotype. Pulsed-field gel electrophoresis found that two clones, with patterns identical to those of serotypes M1 and M4, accounted for 19.4 and 68.1% of the macrolide-resistant isolates, respectively.
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