Nasopharyngeal Carriage, Capsular and Molecular Serotyping and Antimicrobial Susceptibility of Streptococcus pneumoniae among Asymptomatic Healthy Children in Egypt (original) (raw)
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International Journal of Antimicrobial Agents, 2005
The aims of this study were to assess the nasopharyngeal colonisation rate, serogroup and antibiotic susceptibility patterns of Streptococcus pneumoniae strains isolated from healthy children. Of 848 children, 162 (19.1%) were found to be carriers. The carrier rate was significantly higher in the 7-year-old age group. Children from the slums of the city had higher carriage rate (23.7%) than those in the centre of the city (17.7%), but this was not statistically significant. The number of intermediate penicillin-resistant strains was 17 (10.5%). No high-level penicillin-resistant S. pneumoniae strain was found. The rates of resistance to co-trimoxazole, erythromycin, tetracycline and clindamycin were 11.7%, 4.9%, 4.3% and 3.7%, respectively. All isolates were uniformly susceptible to rifampicin, moxifloxacin, levofloxacin and vancomycin. Fourteen different serogroups were identified. The most prevalent serogroups in descending order were 9, 19, 23, 10, 6 and 18, accounting for 76.3% of the isolates. Arbitrarily primed polymerase chain reaction typing of 105 isolates revealed that 25 (23.8%) of the isolates were clonally indistinguishable. This value was 20.9% in children from the central area and 36.8% in those from the slum of the city. There was no relationship between serogroups and genotypes, i.e. strains within the same serogroup yielded the same or different genotypes, and vice versa. In conclusion, serogrouping results give a preliminary idea about the possible coverage of a future pneumococcal vaccine. Penicillin G is still a suitable agent for the empirical treatment of pneumococcal infections in our population. Living in the slum of the city may lead to both increased carriage and clustering rates of S. pneumoniae among healthy children.
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Journal of International Medical Research, 2007
This prospective, multicentre, nasal carriage study in Chinese children with upper respiratory infection was carried out over the period from 2000 to 2002. Overall, the prevalence of pneumococcal carriage was 24.9%. Antimicrobial susceptibility tests were performed for 887 isolates of Streptococcus pneumoniae of which 33.5% were intermediately susceptible to penicillin and 6.4% were resistant. Multidrug resistance was very common. Pneumococcal strains ( n = 625) were serotyped, showing 72.2% were covered by the 23-valent pneumococcal polysaccharide vaccine and 57.6% by the seven-valent pneumococcal conjugate vaccine. Sero-groups 19 and 23 were significantly associated with penicillin resistance, which is increasing in China. Erythromycin, tetracycline and sulphamethoxazole/trimethoprim cannot be recommended as first-line treatments for respiratory tract infection as in some other developing countries. These features of serotype distribution are of importance for surveillance in the ...
Data have been obtained on dynamics of antibiotic susceptibility of Streptococcus pneumoniae isolates circulating in preschool children suffering from respiratory patholo-gies, in the city of Kazan in the years 2009–2015. The high activity of β-lactam antibiotics (from 96 to 90.8 %, depending on the period considered), macrolides (from 83.7 to 93.4 %), and ciprofloxacin (78.9–73.5 %) for the causal treatment of pneumococcal infections. No vancomycin-resistant strains of pneumococci were registered. Comparative analysis of 2009– 2011 and 2015 showed a statistically significant increase of the ratio of resistant strains to penicillin (3.5 %), amoxicillin/ clavulanate (3.9 %), amoxicillin (5.3 %), clarithromycin (3.6 %), clindamycin (2.9 %), ceftriaxone (5.2 %), and cefixime (2.3 %). According to data on serotyping of isolates, serotypes of S. pneumoniae are covered by the 13-valent conjugate vaccine currently used in children by the national calendar of preventive vaccination.
PLoS ONE, 2013
Infections of Streptococcus pneumoniae in children can be prevented by vaccination; left untreated, they cause high morbidity and fatalities. This study aimed at determining the nasopharyngeal carrier rates, serotype distribution and antimicrobial resistance patterns of S. pneumoniae in healthy Palestinian children under age two prior to the full introduction of the pneumococcal 7-valent conjugate vaccine (PCV7), which was originally introduced into Palestine in a pilot trial in September, 2010. In a cross sectional study, nasopharyngeal specimens were collected from 397 healthy children from different Palestinian districts between the beginning of November 2012 to the end of January 2013. Samples were inoculated into blood agar and suspected colonies were examined by amplifying the pneumococcal-specific autolysin gene using a real-time PCR. Serotypes were identified by a PCR that incorporated different sets of specific primers. Antimicrobial susceptibility was measured by disk diffusion and MIC methods. The resulting carrier rate of Streptococcus pneumoniae was 55.7% (221/397). The main serotypes were PCV7 serotypes 19F (12.2%), 23F (9.0%), 6B (8.6%) and 14 (4%) and PCV13 serotypes 6A (13.6%) and 19A (4.1%). Notably, serotype 6A, not included in the pilot trial (PCV7) vaccine, was the most prevalent. Resistance to more than two drugs was observed for bacteria from 34.1% of the children (72/211) while 22.3% (47/211) carried bacteria were susceptible to all tested antibiotics. All the isolates were sensitive to cefotaxime and vancomycin. Any or all of these might impinge on the type and efficacy of the pneumococcal conjugate vaccines and antibiotics to be used for prevention and treatment of pneumococcal disease in the country.
Journal of Medical Microbiology, 2012
This study aimed to determine the magnitude of nasopharyngeal carriage, antimicrobial resistance and serotype distribution of Streptococcus pneumoniae in healthy children under 5 years of age in Tanzania. Nasopharyngeal swabs were obtained from 300 healthy children attending a child health clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania. S. pneumoniae was isolated and identified using conventional methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Penicillin MICs and serotypes were determined by an agar gradient diffusion method and the Quellung reaction, respectively. A total of 105 samples (35 .0%) were positive for S. pneumoniae and 115 serotypes were detected (ten specimens yielded two serotypes each). Overall, 78 of 115 isolates (67.8 %) were penicillin-non-susceptible pneumococci (PNSP). The resistance levels of S. pneumoniae to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, chloramphenicol and ceftriaxone were 82.6, 10.4, 6.0, 3.5 and 0.0 %, respectively. Multidrug resistance was detected in 19 isolates (16.5 %). The most prevalent serotypes were 19F (n = 25, 21.7 %), 6B (n = 15, 13.0 %), 9V (n = 14, 12.2 %) and 13 (n = 14, 12.2 %). Of the 64 pneumococcal isolates potentially covered by the seven-valent pneumococcal conjugate vaccine (PCV7), 44 (68.8 %) were PNSP. A high prevalence of PNSP, common pneumococcal serotypes circulating worldwide, was found, and many of the resistant pneumococci strains are covered by the PCV7. These findings indicate that the carriage rate of such resistant strains could be influenced by an appropriate vaccination programme in the study setting and by reinforcing regulations on the rational use of antimicrobial agents.
Antibiotics
Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance (MDR) of S. pneumoniae strains isolated from healthy children throughout the years 2020–2022. Antimicrobial susceptibility testing of S. pneumoniae strains in selected antimicrobials was performed using disk diffusion and E-test methods on bloodMueller–Hinton agar. The antimicrobials tested included oxacillin, amoxicillin, ceftriaxone, norfloxacin, gentamicin, vancomycin, erythromycin, clindamycin, pristinamycin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole. A total of 201 S. pneumoniae strains were isolated from the nasopharynx of healthy children in Marrakesh, Morocco. The highest rate of resistance of S. pneumoniae was found in penicillin (57.2%), followed by tetracy...
Annals of Tropical Paediatrics: International Child Health, 2001
Background. To assist the Central African Republic (CAR) develop national guidelines for treating children with pneumonia, a survey was conducted to determine antimicrobial resistance rates of nasopharyngeal isolates of Streptococcus pneumoniae (SP) and Haemophilus influenzae (HI). Secondary purposes of the survey were to identify risk factors associated with carriage of a resistant isolate and to compare the survey methods of including only children with pneumonia vs. including all ill children. Methods. A cross-sectional survey of 371 ill children was conducted at 2 outpatient clinics in Bangui, CAR. Results. In all 272 SP isolates and 73 HI isolates were cultured. SP resistance rates to penicillin, trimethoprim-sulfamethoxazole (TMP-SMX), tetracycline and chloramphenicol were 8.8, 6.3, 42.3 and 9.2%, respectively. All penicillin-resistant SP isolates were intermediately resistant. HI resistance rates to ampicillin, TMP-SMX and chloramphenicol were 1.4, 12.3 and 0%, respectively. The most common SP serotypes/groups were 19, 14, 6 and 1; 49% of HI isolates were type b. History of antimicrobial use in the previous 7 days was the only factor associated with carriage of a resistant isolate. Resistance rates were similar among ill children regardless of whether they had pneumonia. Conclusions. Resistance rates were low for antimicrobials recommended by the World Health Organization for children with pneumonia. We recommended TMP-SMX as the first line treatment for pneumonia in CAR because of its low cost, ease of dosing and activity against malaria.
Vaccine, 2011
Objectives: To determine the dynamics of serotype prevalence, potential coverage by pneumococcal conjugate vaccines (PCV) and antibiotic resistance patterns of Streptococcus pneumoniae causing acute otitis media (AOM) in children in southern Israel before PCV7 introduction in the routine immunization program in Israel. Methods: All S. pneumoniae isolates from middle ear fluid from children with AOM during 1999-2008 were included. Prospectively collected demographic data on S. pneumoniae serotypes and antibiotic resistance patterns were analyzed. Results: A total of 14,911 tympanocenteses yielded 5281(35%) S. pneumoniae. Proportion of S. pneumoniae-AOM did not vary significantly (overall 35%; 33% in 2007; 38% in 2002 and 2003). The most frequent serotypes were 19F, 14, 23F and 19A; in both Jewish and Bedouin children; serotypes 6A and 19A contributed 6% and 10%, respectively, of all S. pneumoniae isolates. Serotypes included in PCV7, PCV10 and PCV13 represented 60%, 64%, 85% in Jewish children vs. 49%, 55% and 74%, respectively, in Bedouin children (P < 0.001). Nonsusceptibility to TMP/SMX decreased significantly, in parallel with a significant increase in the nonsusceptibility to erythromycin, clindamycin and in multidrug resistant (MDR) isolates. No changes were recorded in the proportion of S. pneumoniae isolates with penicillin MIC ≥ 1.0 g/ml. The proportion of penicillin-and erythromycin-nonsusceptible and of MDR serotype 6A and 19A isolates increased significantly in Bedouin children. Conclusions: 1) No significant changes were recorded in the yearly proportions of serotypes 23F, 19F, 19A, 14 and 6A in both ethnic populations; 2) Potential coverage of the 3 PCVs was higher in Jewish children than in Bedouin children; 3) The relatively high coverage of macrolides-and multidrug-resistant S. pneumoniae by PCV13 and lack of increase in penicillin, erythromycin and multidrug nonsusceptibility among non-PCV13 isolates is encouraging.