Nasopharyngeal Carriage and Antimicrobial Susceptibility Pattern of Streptococcus Pneumoniae among Pediatric Outpatients at Gondar University Hospital, North West Ethiopia

Assefa, Abate; Gelaw, Baye; Shiferaw, Yitayal; Tigabu, Zemene

doi:10.1016/j.pedneo.2013.03.017

Cited by 39 publications

(69 citation statements)

References 26 publications

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“…This finding is concordant with the results reported from Semarang, Indonesia [30] and from Gondar, Ethiopia [14]. This can be explained by the fact that, younger sibling(s) <5 years old have immunological immaturity and carry S. pneumoniae in their nasopharynx niche in high magnitude.…”

Section: Discussionsupporting

confidence: 92%

“…In the present study, higher nasopharyngeal carriage rate of S. pneumoniae (43.8%) was found among children aged under five years. Similarly high rates have also been found in other countries, with carriage rates ranging from 39% to 43% [14,23] although lower carriage rates (17–24%) were observed in some previous studies [24]. In contrast, much higher carriage rates were seen in a few African countries: 87.0% in Mozambique [25] and 65.8% in Kilifi, Kenya [26].…”

Section: Discussionsupporting

confidence: 65%

“…Factors such as young age [14,25,30], family size more than 5 people [31], having at least one sibling(s) [32], number of rooms in the house [14], exposure to tobacco and cooking fuel smoke [30,33], and underlying diseases [14,31,34] were among factors associated with NP carriage rate as reported by previous studies. In our current study, none of the aforementioned characteristics were found to be risk factors for nasopharyngeal carriage of S. pneumoniae.…”

Section: Discussionmentioning

confidence: 94%

“…In our study, high carriages (53.2%) of tetracycline-resistant pneumococci strains were observed. Tetracycline resistant S. pneumoniae in various studies have been reported to range from 25–65% [14,27]. Tetracycline is one the most commonly available antimicrobials in most public and private health facilities.…”

Section: Discussionmentioning

confidence: 99%

“…Nasopharyngeal colonization by antimicrobial resistant S. pneumoniae has been increasing in different parts of the world including Ethiopia [13,14,15]. In resource-poor settings, therapy remains empiric because of the lack of rapid and accurate diagnostic tests.…”

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal Carriage and Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae among Children under Five in Southwest Ethiopia

et al. 2017

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Nasopharyngeal carriage of Streptococcus pneumoniae is found to play an important role in the development and transmission of pneumococcal diseases. In this study, we assessed the nasopharyngeal carriage, antimicrobial susceptibility patterns and associated risk factors of S. pneumoniae among children under five. A total of 361 children under five attending the outpatient department of Shanan Gibe Hospital in Jimma, Southwest Ethiopia were enrolled from June to September 2014. Nasopharyngeal specimens were collected using sterile plastic applicator rayon tipped swab and inoculated on tryptone soy agar supplemented with 5% sheep blood and 5 µg/mL gentamycin. Antimicrobial susceptibility testing was performed using the modified disk diffusion method. The overall prevalence of S. pneumoniae carriage was 43.8% (158/361) among children under five. Resistance to tetracycline, cotrimoxazole, penicillin, chloramphenicol and erythromycin was observed in 53.2% (84/158), 43.7% (69/158), 36.1% (57/158), 13.3% (21/158) and 8.9% (14/158) of isolates respectively. Multidrug resistance was seen in 17.7% (28/158) of isolates. In multivariate logistic regression analysis, children living with sibling(s) < 5 years old (adjusted odds ratio (AOR) = 1.798; 95% confidence interval (CI), 1.169–2.766) and malnutrition (AOR = 2.065; 95% CI, 1.239–3.443) were significantly associated with S. pneumoniae carriage. A high nasopharyngeal carriage of S. pneumoniae was observed among children under five in Southwest Ethiopia. There should be a strategy to prevent S. pneumoniae nasopharyngeal colonization and identify the appropriate antibiotic to the individual child.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal Carriage and Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae among Children under Five in Southwest Ethiopia

et al. 2017

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Serotypes of Streptococcus pneumoniae in Egyptian children: are they covered by pneumococcal conjugate vaccines?

Badawy

El-Kholy

Sherif

et al. 2017

Eur J Clin Microbiol Infect Dis

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In Egypt, pneumococcal vaccines have not yet been introduced as being compulsory. Identification of the circulating serotypes in Egypt is mandatory to determine whether or not the pneumococcal vaccines will be beneficial. The current study aims to identify the serotypes, vaccine coverage, and antimicrobial resistance of Streptococcus pneumoniae colonizing the nasopharynx of Egyptian children younger than 5 years old. The study was conducted in two successive winter seasons (December 2012-February 2013 and December 2013-February 2014). Two hundred children were enrolled, aged from 6 months to 5 years, excluding those with fever, signs of infection, history of antibiotic intake, and hospitalization in the preceding month. Nasopharyngeal (NP) secretions were collected, subjected to culture, and underwent antibiotic susceptibility testing if positive for pneumococci. Real-time polymerase chain reaction (PCR) and serotyping by sequential multiplex PCR for positive cases were included as well. Streptococcus pneumoniae was isolated from 62 subjects. All isolates were sensitive to vancomycin and levofloxacin, but the majority showed resistance to multiple antibiotics. PCR was positive for pneumococci in 113 subjects (56.5%). The most commonly detected serotypes (st) were 6A6B6C (n = 21, 20.8%), 19F (n = 19, 18.8%), 1 (n = 11, 10.9%), 34 (n = 8, 7.9%), and 19A (n = 6, 5.9%). The theoretical coverage of the PCV13 vaccine for the detected serotypes was 72.4%, while that of PCV10 was 65.5%. Based on these percentages, we recommend including pneumococcal conjugate vaccines in the Egyptian national vaccination program.

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A Systematic Review of Pneumococcal Carriage, Disease, Antimicrobial Resistance, and Vaccination in Egyptian Children Aged 18 Years and Younger

et al. 2021

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Streptococcus pneumoniae remains an important bacterial pathogen, particularly for young children in low- and middle-income countries. A systematic review was conducted of peer-reviewed literature from PubMed published as of May 13, 2020, to identify articles relevant to invasive pneumococcal disease, pneumonia, otitis media (OM), nasopharyngeal carriage (NPC), antimicrobial resistance (AMR), and vaccination coverage in Egypt, with particular focus on children ≤ 18 years of age. A total of 16 relevant articles spanning three decades were included in this review. Among studies reviewed, S. pneumoniae was the causative agent of meningitis in 21–30% of cases among hospitalized children between 1983 and 2003. One study showed that serotypes 6A and 6B predominated among meningitis cases of pediatric patients aged < 5 years. This review also revealed that S. pneumoniae was the most commonly identified bacterial pathogen of acute mastoiditis, a severe complication of acute OM, among children aged 9 months to 11 years. NPC studies showed that approximately 30% of Egyptian children were carriers of S. pneumoniae . AMR, especially to penicillin, continues to be a growing concern in low- and middle-income countries, including among Egyptian children. Several predominant serotypes were identified to be associated with penicillin resistance, such as 6B, 1, 19A, 23F, and 6A. Currently available pneumococcal vaccines (PCVs) such as PCV10 and PCV13 may provide coverage against the most prevalent circulating serotypes among Egyptian children. Comprehensive disease surveillance and immunization programs are needed to ensure that this vulnerable population is sufficiently protected against pneumococcal disease.

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Nasopharyngeal Carriage and Antimicrobial Susceptibility Pattern of Streptococcus Pneumoniae among Pediatric Outpatients at Gondar University Hospital, North West Ethiopia

Abstract: The S. pneumoniae carriage rate was higher among younger children. High antimicrobial resistance of S. pneumoniae against erythromycin, tetracycline, and cotrimoxazole was observed. Being in the young age group and living with younger children are risk factors for pneumococcal carriage.

Cited by 39 publications

References 26 publications

Nasopharyngeal Carriage and Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae among Children under Five in Southwest Ethiopia

Nasopharyngeal Carriage and Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae among Children under Five in Southwest Ethiopia

Serotypes of Streptococcus pneumoniae in Egyptian children: are they covered by pneumococcal conjugate vaccines?

A Systematic Review of Pneumococcal Carriage, Disease, Antimicrobial Resistance, and Vaccination in Egyptian Children Aged 18 Years and Younger

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