1887

Abstract

Sickle cell disease (SCD) children have a high susceptibility to pneumococcal infection. For this reason, they are routinely immunized with pneumococcal vaccines and use antibiotic prophylaxis (AP).

Yet, little is known about SCD children’s gut microbiota. If antibiotic-resistant may colonize people on AP, we hypothesized that SCD children on AP are colonized by resistant enterobacteria species.

To evaluate the effect of continuous AP on gut colonization from children with SCD.

We analysed 30 faecal swabs from SCD children on AP and 21 swabs from children without the same condition. was isolated on MacConkey agar plates and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (bioMérieux, Marcy l'Etoile, France). We performed the antibiogram by Vitek 2 system (bioMérieux, Marcy l'Etoile, France), and the resistance genes were identified by multiplex PCR.

We found four different species with resistance to one or more different antibiotic types in the AP-SCD children’s group: , , , and . Colonization by resistant was associated with AP (prevalence ratio 2.69, 95 % confidence interval [CI], 1.98–3.67, <0.001). Strains producing extended-spectrum β-lactamases (ESBL) were identified only in SCD children, , 4/30 (13 %), and , 2/30 (7 %). The ESBL-producing were associated with penicillin G benzathine use (95 % CI, 22.91–86.71, <0.001). CTX-M-1 was the most prevalent among ESBL-producers (3/6, 50 %), followed by CTX-M-9 (2/6, 33 %), and CTX-M-2 (1/6, 17 %).

Resistant enterobacteria colonize SCD children on AP, and this therapy raises the chance of ESBL-producing colonization. Future studies should focus on prophylactic vaccines as exclusive therapy against pneumococcal infections.

Funding
This study was supported by the:
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Award 001)
    • Principle Award Recipient: de Souza Santos MonteiroAdriano
  • Fundação de Amparo à Pesquisa do Estado da Bahia (Award SUS0036/2018)
    • Principle Award Recipient: ApplicableNot
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2021-09-03
2021-09-16
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