Carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Indonesian children: A cross-sectional study

Abstract

Streptococcus pneumoniae is an important cause of infection and commonly colonizes the nasopharynx of young children, along with other potentially pathogenic bacteria. The objectives of this study were to estimate the carriage prevalence of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in young children in Indonesia, and to examine interactions between these bacterial species. 302 healthy children aged 12–24 months were enrolled in community health centers in the Bandung, Central Lombok, and Padang regions. Nasopharyngeal swabs were collected and stored according to World Health Organization recommendations, and bacterial species detected by qPCR. Pneumococcal serotyping was conducted by microarray and latex agglutination/Quellung. Overall carriage prevalence was 49.5% for S. pneumoniae, 27.5% for H. influenzae, 42.7% for M. catarrhalis, and 7.3% for S. aureus. Prevalence of M. catarrhalis and S. pneumoniae, as well as pneumococcal serotype distribution, varied by region. Positive associations were observed for S. pneumoniae and M. catarrhalis (OR 3.07 [95%CI 1.91–4.94]), and H. influenzae and M. catarrhalis (OR 2.34 [95%CI 1.40–3.91]), and a negative association was found between M. catarrhalis and S. aureus (OR 0.06 [95%CI 0.01–0.43]). Densities of S. pneumoniae, H. influenzae, and M. catarrhalis were positively correlated when two of these species were present. Prior to pneumococcal vaccine introduction, pneumococcal carriage prevalence and serotype distribution varies among children living in different regions of Indonesia. Positive associations in both carriage and density identified among S. pneumoniae, H. influenzae, and M. catarrhalis suggest a synergistic relationship among these species with potential clinical implications.

The dynamics and interactions of respiratory pathogen carriage among French pilgrims during the 2018 Hajj

“…Dual carriage of H. influenzae and M. catarrhalis strongly associated with S. pneumoniae carriage which in turns associated with M catarrhalis carriage. These results are consistent with those of several studies conducted among children with upper RTIs [38][39][40]. In these studies, the competitive interaction between S. pneumoniae and H. influenzae was dependent on neutrophils and complement.…”

Respiratory Carriage of Haemophilus influenzae Associated with Hib Vaccine in Jordanian Children

“…Our results are consistent with those of many recent studies, where, after introduction of the Hib conjugate vaccine, Hib has rarely been found in the upper respiratory tract of children, or as a cause of invasive disease, while the incidence of carriage and disease with NTHi strains has proportionally increased. 3,17,18 Furthermore, the carriage prevalence of NTHi in nasopharyngeal cultures varies according to the age, disease, geographic location, crowding, and socioeconomic factors of individuals. 18,19 A recent study from 12 European countries investigated the epidemiology of invasive H. influenzae disease trend according to its serotype and patient age during 2007 to 2014.…”

“…3,17,18 Furthermore, the carriage prevalence of NTHi in nasopharyngeal cultures varies according to the age, disease, geographic location, crowding, and socioeconomic factors of individuals. 18,19 A recent study from 12 European countries investigated the epidemiology of invasive H. influenzae disease trend according to its serotype and patient age during 2007 to 2014. 15 The study indicated that the mean annual notification rate was 0.6 cases/100,000 individuals, with an increasing annual trend of 3.3%.…”

“…In addition, a recent study performed in Indonesia in 2018 found that the nasopharyngeal carriage of NTHi in Indonesian children was 27.5% (83/302), and the Hib isolates were not detected. 18 The reason is most likely introduction of universal Hib vaccination in these countries. 15 Numerous studies have reported the role of NTHi as cause of mainly noninvasive local infections in children, such as AOM, sinusitis, bronchitis, pneumonia, and conjunctivitis.…”

Biological activity of sponge-associated fungi from Karimunjawa Islands, Indonesia against pathogenic Streptococcus pneumoniae

“…This multidrug-resistant (MDR) bacteria may cause pneumonia, sepsis, meningitis, otitis media (O'Brien et al 2009;Mirza et al 2011;Hu et al 2016;Cherazard et al 2017), bloodstream infections and sinus infections in young children (CDC 2017). In Indonesia research on people with pneumococcal infection has already been carried out in the following areas: Jakarta (Yuliarti et al 2012), Bandung, Central Lombok, and Padang West Sumatera (Dunne et al 2018). The prevalence of carriers of S. pneumoniae among the healthy population has been sharply increasing ( DKP-Jateng 2014; Farida et al 2014;Ditjen P2P 2018) and multidrugresistant bacteria can pose a growing threat to general health (Lestari et al 2012).…”