Abstract

From January 1986 through December 1990,672 cases of invasive pneumococcal disease were

identified. From these, 574 pneumococcal isolates were recovered from normally sterile sites

(blood, cerebrospinal and pleural fluid); 92% were serotypes represented in the 23-valent pneumococcal

polysaccharide vaccine. The most common serotypes from children <2 years old were

4, 6B, 9V, 14, 18C, 19F, and 23F, recovered from 83% ofAlaska Native and 75.1%ofnonnative

children with invasive disease. Moderate penicillin resistance (MIC, 0.1-1.0 “”g/mL) was found

in 3.8% of isolates. All were sensitive to chloramphenicol, vancomycin, rifampin, ceftriaxone,

cefotaxime, cephalothin, and cefaclor. However, in the Yukon-Kuskokwim Delta region, 16.9%

of isolates were moderately resistant to penicillin, and 10.8% were resistant to erythromycin and

6.2% to trimethoprim-sulfamethoxazole; the number resistant to two or more antibiotics increased

significantly during surveillance. All multiply resistant isolates were serotype 6B, and all

were from Alaska Native patients < 2 years old.

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