Nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers.


Hill, PC; Akisanya, A; Sankareh, K; Cheung, YB; Saaka, M; Lahai, G; Greenwood, BM; Adegbola, RA; (2006) Nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers. Clinical infectious diseases , 43 (6). pp. 673-9. ISSN 1058-4838 DOI: 10.1086/506941

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Abstract

BACKGROUND: To prepare for the introduction of a pneumococcal conjugate vaccine of restricted valency, we studied the nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers. METHODS: A cross-sectional survey was conducted in 21 villages after a census. We recorded demographic characteristics, information on medical history, and data on possible risk factors for carriage from subjects. We collected a nasopharyngeal swab specimen from each subject for isolation and serotyping of S. pneumoniae and for antibiotic susceptibility testing. RESULTS: The prevalence of S. pneumoniae carriage among 2872 villagers was 72%. It was highest among infants (i.e., children aged <1 year; 97%); the rate was 93% among babies aged <1 month and decreased with increasing age (P<.001). Prevalence of carriage was linked to proximity to another village. Sixty-three percent of isolates recovered from children aged <5 years were covered by the 7-valent vaccine or were of a vaccine-related serotype, compared with 43% of isolates overall. Forty-three isolates (14.3%) tested were initially penicillin resistant; none had high-level resistance, and 4 had intermediate resistance. The rates of resistance to other antibiotics were as follows: trimethoprim-sulfamethoxazole, 39%; tetracycline, 32.3%; chloramphenicol, 6.3%; cefotaxime, 0.3%; and erythromycin, 0%. The rates were highest for isolates of vaccine serotypes. CONCLUSIONS: Pneumococcal carriage rates among Gambian villagers are very high. A pneumococcal conjugate vaccine of restricted valency should reduce the pool of antibiotic-resistant pneumococci. The large reservoir of pneumococci of nonvaccine serotypes will require close monitoring when the vaccine is introduced.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Vaccine Centre
Tropical Epidemiology Group
PubMed ID: 16912937
Web of Science ID: 240050000001
URI: http://researchonline.lshtm.ac.uk/id/eprint/11466

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