1887

Abstract

This study aimed to determine the magnitude of nasopharyngeal carriage, antimicrobial resistance and serotype distribution of in healthy children under 5 years of age in Tanzania. Nasopharyngeal swabs were obtained from 300 healthy children attending a child health clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania. was isolated and identified using conventional methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method. Penicillin MICs and serotypes were determined by an agar gradient diffusion method and the Quellung reaction, respectively. A total of 105 samples (35 .0%) were positive for and 115 serotypes were detected (ten specimens yielded two serotypes each). Overall, 78 of 115 isolates (67.8 %) were penicillin-non-susceptible pneumococci (PNSP). The resistance levels of to trimethoprim–sulfamethoxazole, tetracycline, erythromycin, chloramphenicol and ceftriaxone were 82.6, 10.4, 6.0, 3.5 and 0.0 %, respectively. Multidrug resistance was detected in 19 isolates (16.5 %). The most prevalent serotypes were 19F ( = 25, 21.7 %), 6B ( = 15, 13.0 %), 9V ( = 14, 12.2 %) and 13 ( = 14, 12.2 %). Of the 64 pneumococcal isolates potentially covered by the seven-valent pneumococcal conjugate vaccine (PCV7), 44 (68.8 %) were PNSP. A high prevalence of PNSP, common pneumococcal serotypes circulating worldwide, was found, and many of the resistant pneumococci strains are covered by the PCV7. These findings indicate that the carriage rate of such resistant strains could be influenced by an appropriate vaccination programme in the study setting and by reinforcing regulations on the rational use of antimicrobial agents.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.042598-0
2012-07-01
2019-10-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/7/952.html?itemId=/content/journal/jmm/10.1099/jmm.0.042598-0&mimeType=html&fmt=ahah

References

  1. Abdullahi O. , Nyiro J. , Lewa P. , Slack M. , Scott J. A. . ( 2008; ). The descriptive epidemiology of Streptococcus pneumoniae and Haemophilus influenzae nasopharyngeal carriage in children and adults in Kilifi district, Kenya. . Pediatr Infect Dis J 27:, 59–64. [CrossRef] [PubMed]
    [Google Scholar]
  2. Appelbaum P. C. . ( 1992; ). Antimicrobial resistance in Streptococcus pneumoniae: an overview. . Clin Infect Dis 15:, 77–83. [CrossRef] [PubMed]
    [Google Scholar]
  3. Arason V. A. , Sigurdsson J. A. , Erlendsdottir H. , Gudmundsson S. , Kristinsson K. G. . ( 2006; ). The role of antimicrobial use in the epidemiology of resistant pneumococci: a 10-year follow up. . Microb Drug Resist 12:, 169–176. [CrossRef] [PubMed]
    [Google Scholar]
  4. Batt S. L. , Charalambous B. M. , Solomon A. W. , Knirsch C. , Massae P. A. , Safari S. , Sam N. E. , Everett D. , Mabey D. C. , Gillespie S. H. . ( 2003; ). Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae . . Antimicrob Agents Chemother 47:, 2765–2769. [CrossRef] [PubMed]
    [Google Scholar]
  5. Blomberg B. , Manji K. P. , Urassa W. K. , Tamim B. S. , Mwakagile D. S. , Jureen R. , Msangi V. , Tellevik M. G. , Holberg-Petersen M. . & other authors ( 2007; ). Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study. . BMC Infect Dis 7:, 43. [CrossRef] [PubMed]
    [Google Scholar]
  6. Bogaert D. , De Groot R. , Hermans P. W. . ( 2004; ). Streptococcus pneumoniae colonisation: the key to pneumococcal disease. . Lancet Infect Dis 4:, 144–154. [CrossRef] [PubMed]
    [Google Scholar]
  7. Breiman R. F. , Butler J. C. , Tenover F. C. , Elliott J. A. , Facklam R. R. . ( 1994; ). Emergence of drug-resistant pneumococcal infections in the United States. . JAMA 271:, 1831–1835. [CrossRef] [PubMed]
    [Google Scholar]
  8. Brueggemann A. B. , Griffiths D. T. , Meats E. , Peto T. , Crook D. W. , Spratt B. G. . ( 2003; ). Clonal relationships between invasive and carriage Streptococcus pneumoniae and serotype- and clone-specific differences in invasive disease potential. . J Infect Dis 187:, 1424–1432. [CrossRef] [PubMed]
    [Google Scholar]
  9. Charalambous B. M. , Oriyo N. M. , Gillespie S. H. . ( 2008; ). How valid is single-colony isolation for surveillance of Streptococcus pneumoniae carriage?. J Clin Microbiol 46:, 2467–2468. [CrossRef] [PubMed]
    [Google Scholar]
  10. Chiu S. S. , Ho P. L. , Chow F. K. , Yuen K. Y. , Lau Y. L. . ( 2001; ). Nasopharyngeal carriage of antimicrobial-resistant Streptococcus pneumoniae among young children attending 79 kindergartens and day care centers in Hong Kong. . Antimicrob Agents Chemother 45:, 2765–2770. [CrossRef] [PubMed]
    [Google Scholar]
  11. CLSI ( 2010; ). Performance Standards for Antimicrobial Susceptibility Testing, 20th Informational Supplement. M100-S20. Wayne, PA: Clinical and Laboratory Standards Institute.
  12. Critchley I. A. , Thornsberry C. , Piazza G. , Jones M. , Hickey M. L. , Barth A. L. , Mendes C. , Rossi F. F. , Sader H. S. . & other authors ( 2000; ). Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis collected from five centers in Brazil, 1997–98. . Clin Microbiol Infect 6:, 178–184. [CrossRef] [PubMed]
    [Google Scholar]
  13. Dagan R. , Klugman K. P. . ( 2008; ). Impact of conjugate pneumococcal vaccines on antibiotic resistance. . Lancet Infect Dis 8:, 785–795. [CrossRef] [PubMed]
    [Google Scholar]
  14. de Andrade A. L. , Pimenta F. C. , Brandileone M. C. , Laval C. A. , Guerra M. L. , de Andrade J. G. , Di Fabio J. L. . ( 2003; ). Genetic relationship between Streptococcus pneumoniae isolates from nasopharyngeal and cerebrospinal fluid of two infants with pneumococcal meningitis. . J Clin Microbiol 41:, 3970–3972. [CrossRef] [PubMed]
    [Google Scholar]
  15. Fairchok M. P. , Ashton W. S. , Fischer G. W. . ( 1996; ). Carriage of penicillin-resistant pneumococci in a military population in Washington, DC: risk factors and correlation with clinical isolates. . Clin Infect Dis 22:, 966–972. [CrossRef] [PubMed]
    [Google Scholar]
  16. Feikin D. R. , Davis M. , Nwanyanwu O. C. , Kazembe P. N. , Barat L. M. , Wasas A. , Bloland P. B. , Ziba C. , Capper T. . & other authors ( 2003; ). Antibiotic resistance and serotype distribution of Streptococcus pneumoniae colonizing rural Malawian children. . Pediatr Infect Dis J 22:, 564–567. [CrossRef] [PubMed]
    [Google Scholar]
  17. Friedland I. R. , McCracken G. H. Jr . ( 1994; ). Management of infections caused by antibiotic-resistant Streptococcus pneumoniae . . N Engl J Med 331:, 377–382. [CrossRef] [PubMed]
    [Google Scholar]
  18. Hausdorff W. P. , Feikin D. R. , Klugman K. . ( 2005; ). Epidemiological differences among pneumococcal serotypes. . Lancet Infect Dis 5:, 83–93.[CrossRef]
    [Google Scholar]
  19. Hill P. C. , Akisanya A. , Sankareh K. , Cheung Y. B. , Saaka M. , Lahai G. , Greenwood B. M. , Adegbola R. A. . ( 2006; ). Nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers. . Clin Infect Dis 43:, 673–679. [CrossRef] [PubMed]
    [Google Scholar]
  20. Högberg L. , Ekdahl K. , Sjöström K. , Olsson-Liljequist B. , Walder M. , Melander E. , Ringberg H. , Normark B. H. . ( 2006; ). Penicillin-resistant pneumococci in Sweden 1997–2003: increased multiresistance despite stable prevalence and decreased antibiotic use. . Microb Drug Resist 12:, 16–22. [CrossRef] [PubMed]
    [Google Scholar]
  21. Homøe P. , Prag J. , Farholt S. , Henrichsen J. , Hornsleth A. , Kilian M. , Jensen J. S. . ( 1996; ). High rate of nasopharyngeal carriage of potential pathogens among children in Greenland: results of a clinical survey of middle-ear disease. . Clin Infect Dis 23:, 1081–1090. [CrossRef] [PubMed]
    [Google Scholar]
  22. Huebner R. E. , Wasas A. , Mushi A. , Mazhani L. , Klugman K. . ( 1998; ). Nasopharyngeal carriage and antimicrobial resistance in isolates of Streptococcus pneumoniae and Haemophilus influenzae type b in children under 5 years of age in Botswana. . Int J Infect Dis 3:, 18–25. [CrossRef] [PubMed]
    [Google Scholar]
  23. Inverarity D. , Diggle M. , Ure R. , Johnson P. , Altstadt P. , Mitchell T. , Edwards G. , Santana-Hernandez D. . ( 2011; ). Molecular epidemiology and genetic diversity of pneumococcal carriage among children in Beni State, Bolivia. . Trans R Soc Trop Med Hyg 105:, 445–451. [CrossRef] [PubMed]
    [Google Scholar]
  24. Jacobs M. R. . ( 1999; ). Drug-resistant Streptococcus pneumoniae: rational antibiotic choices. . Am J Med 106:, 19S–25S, discussion 48S–52S. [CrossRef] [PubMed]
    [Google Scholar]
  25. Johnson D. M. , Stilwell M. G. , Fritsche T. R. , Jones R. N. . ( 2006; ). Emergence of multidrug-resistant Streptococcus pneumoniae: report from the SENTRY Antimicrobial Surveillance Program (1999–2003). . Diagn Microbiol Infect Dis 56:, 69–74. [CrossRef] [PubMed]
    [Google Scholar]
  26. Joloba M. L. , Bajaksouzian S. , Palavecino E. , Whalen C. , Jacobs M. R. . ( 2001; ). High prevalence of carriage of antibiotic-resistant Streptococcus pneumoniae in children in Kampala Uganda. . Int J Antimicrob Agents 17:, 395–400. [CrossRef] [PubMed]
    [Google Scholar]
  27. Jones M. E. , Blosser-Middleton R. S. , Thornsberry C. , Karlowsky J. A. , Sahm D. F. . ( 2003; ). The activity of levofloxacin and other antimicrobials against clinical isolates of Streptococcus pneumoniae collected worldwide during 1999–2002. . Diagn Microbiol Infect Dis 47:, 579–586. [CrossRef] [PubMed]
    [Google Scholar]
  28. Kiska D. L. , Kerr A. , Jones M. C. , Chazotte N. N. , Eskridge B. , Miller S. , Jordan M. , Sheaffer C. , Gilligan P. H. . ( 1995; ). Comparison of antimicrobial susceptibility methods for detection of penicillin-resistant Streptococcus pneumoniae . . J Clin Microbiol 33:, 229–232.[PubMed]
    [Google Scholar]
  29. Leung M. H. , Oriyo N. M. , Gillespie S. H. , Charalambous B. M. . ( 2011; ). The adaptive potential during nasopharyngeal colonisation of Streptococcus pneumoniae . . Infect Genet Evol 11:, 1989–1995. [CrossRef] [PubMed]
    [Google Scholar]
  30. O’Brien K. L. , Bronsdon M. A. , Dagan R. , Yagupsky P. , Janco J. , Elliott J. , Whitney C. G. , Yang Y. H. , Robinson L. G. . & other authors ( 2001; ). Evaluation of a medium (STGG) for transport and optimal recovery of Streptococcus pneumoniae from nasopharyngeal secretions collected during field studies. . J Clin Microbiol 39:, 1021–1024. [CrossRef] [PubMed]
    [Google Scholar]
  31. Ochoa T. J. , Rupa R. , Guerra H. , Hernandez H. , Chaparro E. , Tamariz J. , Wanger A. , Mason E. O. Jr . ( 2005; ). Penicillin resistance and serotypes/serogroups of Streptococcus pneumoniae in nasopharyngeal carrier children younger than 2 years in Lima, Peru. . Diagn Microbiol Infect Dis 52:, 59–64. [CrossRef] [PubMed]
    [Google Scholar]
  32. Okeke I. N. , Laxminarayan R. , Bhutta Z. A. , Duse A. G. , Jenkins P. , O’Brien T. F. , Pablos-Mendez A. , Klugman K. P. . ( 2005; ). Antimicrobial resistance in developing countries. Part I: recent trends and current status. . Lancet Infect Dis 5:, 481–493. [CrossRef] [PubMed]
    [Google Scholar]
  33. Paraskakis I. , Kafetzis D. A. , Chrisakis A. , Papavasilliou H. , Kirikou H. , Pangalis A. , Tzouvelekis L. S. , Athanasiou T. , Legakis N. J. . National Surveillance Network for Pneumococcal Resistance ( 2006; ). Serotypes and antimicrobial susceptibilities of 1033 pneumococci isolated from children in Greece during 2001–2004. . Clin Microbiol Infect 12:, 490–493. [CrossRef] [PubMed]
    [Google Scholar]
  34. Pease A. A. , Douglas C. W. , Spencer R. C. . ( 1986; ). Identifying non-capsulate strains of Streptococcus pneumoniae isolated from eyes. . J Clin Pathol 39:, 871–875. [CrossRef] [PubMed]
    [Google Scholar]
  35. Poulakou G. , Katsarolis I. , Matthaiopoulou I. , Tsiodras S. , Kanavaki S. , Hatzaki D. , Roilides E. , Sofianou D. , Kavaliotis I. . & other authors ( 2007; ). Nationwide surveillance of Streptococcus pneumoniae in Greece: patterns of resistance and serotype epidemiology. . Int J Antimicrob Agents 30:, 87–92. [CrossRef] [PubMed]
    [Google Scholar]
  36. Rey L. C. , Wolf B. , Moreira J. L. , Milatovic D. , Verhoef J. , Farhat C. K. . ( 2002; ). Antimicrobial susceptibility and serotypes of nasopharyngeal Streptococcus pneumoniae in children with pneumonia and in children attending day-care centres in Fortaleza, Brazil. . Int J Antimicrob Agents 20:, 86–92. [CrossRef] [PubMed]
    [Google Scholar]
  37. Rusen I. D. , Fraser-Roberts L. , Slaney L. , Ombette J. , Lovgren M. , Datta P. , Ndinya-Achola J. , Talbot J. A. , Nagelkerke N. . & other authors ( 1997; ). Nasopharyngeal pneumococcal colonization among Kenyan children: antibiotic resistance, strain types and associations with human immunodeficiency virus type 1 infection. . Pediatr Infect Dis J 16:, 656–662. [CrossRef] [PubMed]
    [Google Scholar]
  38. Samore M. H. , Magill M. K. , Alder S. C. , Severina E. , Morrison-De Boer L. , Lyon J. L. , Carroll K. , Leary J. , Stone M. B. . & other authors ( 2001; ). High rates of multiple antibiotic resistance in Streptococcus pneumoniae from healthy children living in isolated rural communities: association with cephalosporin use and intrafamilial transmission. . Pediatrics 108:, 856–865. [CrossRef] [PubMed]
    [Google Scholar]
  39. Tleyjeh I. M. , Tlaygeh H. M. , Hejal R. , Montori V. M. , Baddour L. M. . ( 2006; ). The impact of penicillin resistance on short-term mortality in hospitalized adults with pneumococcal pneumonia: a systematic review and meta-analysis. . Clin Infect Dis 42:, 788–797. [CrossRef] [PubMed]
    [Google Scholar]
  40. Whitney C. G. , Farley M. M. , Hadler J. , Harrison L. H. , Lexau C. , Reingold A. , Lefkowitz L. , Cieslak P. R. , Cetron M. . & other authors ( 2000; ). Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. . N Engl J Med 343:, 1917–1924. [CrossRef] [PubMed]
    [Google Scholar]
  41. Woolfson A. , Huebner R. , Wasas A. , Chola S. , Godfrey-Faussett P. , Klugman K. . ( 1997; ). Nasopharyngeal carriage of community-acquired, antibiotic-resistant Streptococcus pneumoniae in a Zambian paediatric population. . Bull World Health Organ 75:, 453–462.[PubMed]
    [Google Scholar]
  42. WHO ( 2007; ). Pneumococcal conjugate vaccine for childhood immunization – WHO position paper. . Wkly Epidemiol Rec 82:, 93–104.[PubMed]
    [Google Scholar]
  43. Yao K. H. , Lu Q. , Deng L. , Yu S. J. , Zhang H. , Deng Q. L. , Shen X. Z. , Yang Y. H. . ( 2005; ). [Carrier rate of Streptococcus pneumoniae and susceptibility thereof to antimicrobial drugs among children in China: a surveillance study in Beijing, Shanghai, and Guangzhou 2000-2002]. . Zhonghua Yi Xue Za Zhi 85:, 1957–1961 (in Chinese).[PubMed]
    [Google Scholar]
  44. Yu S. , Yao K. , Shen X. , Zhang W. , Liu X. , Yang Y. . ( 2008; ). Serogroup distribution and antimicrobial resistance of nasopharyngeal isolates of Streptococcus pneumoniae among Beijing children with upper respiratory infections (2000–2005). . Eur J Clin Microbiol Infect Dis 27:, 649–655. [CrossRef] [PubMed]
    [Google Scholar]
  45. Zhanel G. G. , Karlowsky J. A. , Palatnick L. , Vercaigne L. , Low D. E. , The Canadian Respiratory Infection Study Group Hoban D. J. . ( 1999; ). Prevalence of antimicrobial resistance in respiratory tract isolates of Streptococcus pneumoniae: results of a Canadian national surveillance study. . Antimicrob Agents Chemother 43:, 2504–2509.[PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.042598-0
Loading
/content/journal/jmm/10.1099/jmm.0.042598-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error