Factors Associated with Streptococcus pneumoniae Nasopharyngeal Carriage and Antimicrobial Susceptibility among Children Under the Age of 5 Years in the Southwestern Colombia

Abstract

Objective This work aims to evaluate the factors associated with Streptococcus pneumoniae nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in southwestern Colombia, 2019. Methods A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage. Results A total of 452 children under the age of 5 years were examined in which 41.8% carried S. pneumoniae. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%). Conclusion The 41.8% of participants carrying S. pneumoniae show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.

Pneumococcal Diseases in Colombia: Epidemiological Analysis Before and During the Universal Children Immunization against Streptococcus pneumoniae in the Light of a Vaccine Change in 2022

“…Additionally, a 2019 study to determine the rate of nasopharyngeal carriage in children under 5 years of age, conducted in Cali, reported high rates of resistance. Decreased sensitivity to penicillin (57%), ceftriaxone (21%), erythromycin (40%), trimethoprimsulfamethoxazole (36%), and clindamycin (24%) was detected, evidencing the importance of colonization as a reservoir of multi-resistant isolates with an impact on transmission and subsequent IPDs in this population 50 . Finally, data from the Pneumo-Colombia Network have shown that serotypes 19A, 6A, 14, 23F and 6C are the ones that exhibit a higher resistance pattern.…”

Prevalence of Pneumococcal Carriage among Jordanian Infants in the First 6 Months of Age, 2008–2016

“…Previous studies reported the attendance at day care as a main factor causing the increase of the carriage rate of S. pneumoniae [25]. However, higher pneumococcal carriage frequencies were observed among participants aged <2 years, and in individuals belonging to indigenous communities lacking established pneumococcal-conjugated vaccine immunization schemes, as found in Southwestern Columbia [26]. The distribution and prevalence of the pneumococcal serotypes and carriage varies geographically, therefore it is essential to perform pneumococcal prevalence studies in different geographical areas [27].…”

Inborn Errors of Immunity among Egyptian Children with Recurrent Acute Otitis Media

“…Otitis-prone children have underlying dysfunctions in immune defense mechanisms, including innate immunity (e.g., inadequate response of proinflammatory cytokines and poor repair of epithelial cells in the nasopharynx) and adaptive immunity (e.g., dysfunction of B cells and immunologic memory with low antibody production to otopathogen-specific antigens as well as dysfunction of CD4 þ and CD8 þ T cells). 3,21,22 Besides these minor immunological aberrations, a small but important subset of children with rAOM has well-defined IEIs. 7 The present study identified a relatively high frequency of IEIs in children with rAOM (one of every five children).…”