Nasopharyngeal Colonization, Associated Factors and Antimicrobial Resistance ofStreptococcus pneumoniaeamong Children under 5 Years of Age in the Southwestern Colombia

Abstract

Streptococcus pneumoniae diseases are important causes of children death worldwide. Nasopharyngeal carriage of this pathobiont promotes bacterial spread and infections in the community. Here, a cross-sectional surveillance study was done to determine the proportion of nasopharyngeal colonization, antimicrobial susceptibility profile and associated factors in pediatric outpatients (southwestern Colombia, 2019). Data on factors associated with pneumococcal nasopharyngeal carriage were obtained through survey-based interviews. Nasopharyngeal swabs were collected and bacteria were microbiologically characterized. Antimicrobial susceptibility tests were done by VITEK-2. A logistic regression analysis was performed to examine associated factors. Tests with a p-value <0.05 were considered statistically significant. 452 children from the southwestern Colombia were examined and 41.8% carried S. pneumoniae. A higher pneumococcal carriage frequency was observed among participants <2-years and in individuals belonging to indigenous communities, which were not immunized against pneumococcus, because of lacking established immunization schemes. Additionally, children attending child-care institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% non-susceptibility 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%). The proportion of 41.8% of participants carrying S. pneumoniae shows a scenario with the presence of strains resistant to different antimicrobial agents (MDR and XDR), which constitutes important reservoirs of bacterial transmission by children <5-years in the southwest of Colombia. This situation could potentially lead to an onset of pneumococcal diseases. Hence, the need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.

Nasopharyngeal carriage of Streptococcus pneumoniae in Latin America and the Caribbean: A systematic review and meta-analysis

“…León 2019 [ 83 ] focused on indigenous communities in Ecuador and highlighted the need for studies on respiratory pathogen colonization in high-risk groups. Gámez 2020 [ 84 ] investigated nasopharyngeal colonization in children in southwestern Colombia and found a high frequency of S . pneumoniae carriage, including strains resistant to multiple antimicrobial agents.…”

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 + and CD8 + T cells). 3 21 22 Besides these minor immunological aberrations, a small but important subset of children with rAOM has well-defined IEIs. 7…”