Pneumococcal nasopharyngeal carriage and patterns of penicillin resistance in young children in Fiji


Russell, FM; Carapetis, JR; Ketaiwai, S; Kunabuli, V; Taoi, M; Biribo, S; Seduadua, A; Mulholland, EK; (2006) Pneumococcal nasopharyngeal carriage and patterns of penicillin resistance in young children in Fiji. Annals of tropical paediatrics, 26 (3). pp. 187-197. ISSN 0272-4936 DOI: https://doi.org/10.1179/146532806X120273

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Abstract

Background: Little is known about nasopharyngeal carriage and the patterns of antibiotic resistance of pneumococci in Pacific nations. We set out to document pneumococcal nasopharyngeal carriage and associated risk factors, antimicrobial resistance and serotypes in healthy children in Fiji. Methods: A cross-sectional survey of healthy children aged 3-13 months was conducted. Nasopharyngeal (NP) swabs were collected from each child and processed according to standard methods. Antimicrobial resistance was determined by disk diffusion and confirmed by E-testing. Serotyping was performed by the Quellung reaction. Results: Of 440 consecutive NP swabs taken, 195 were S. pneumoniae-positive (carriage rate 44.3%). Higher rates were found in the indigenous Fijian population. Penicillin non-susceptibility was found in 11.4% of isolates, with one isolate demonstrating high-level resistance. Cotrimoxazole resistance was common (20.3%) and no isolates were chloramphenicol-resistant. Multi-drug resistance was uncommon. The commonest serotypes were 6A (13.2%), 23F (8.3%), 19F (7.4%) and 6B (6.2%). Thirty per cent were included in the 7-valent pneumococcal conjugate vaccine (PCV), 54.3% if cross-reacting strains were included. Being indigenous Fijian or having symptoms of acute respiratory infection were independent risk factors for carriage. Conclusions: Pneumococcal NP carriage is common in Fijian children. Penicillin resistance has been documented for the first time in Fiji and, as a result, first-line treatment for meningitis has been altered. Being indigenous Fijian is a risk factor for disease, although the reasons for this are unclear. A low proportion of carriage serotypes are covered by the existing 7-valent PCV.

Item Type: Article
Keywords: UPPER RESPIRATORY-TRACT, PAPUA-NEW-GUINEA, DAY-CARE-CENTERS, STREPTOCOCCUS-PNEUMONIAE, HAEMOPHILUS-INFLUENZAE, CONJUGATE VACCINE, OTITIS-MEDIA, ANTIMICROBIAL RESISTANCE, MOLECULAR EPIDEMIOLOGY, BACTERIAL-COLONIZATION, Carrier State, epidemiology, microbiology, Cross-Sectional Studies, Female, Fiji, epidemiology, Humans, Infant, Male, Microbial Sensitivity Tests, Nasopharynx, microbiology, Penicillin Resistance, Pneumococcal Infections, drug therapy, epidemiology, microbiology, Risk Factors, Socioeconomic Factors, Streptococcus pneumoniae, classification, drug effects, isolation & purification
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 16925955
Web of Science ID: 240143000004
URI: http://researchonline.lshtm.ac.uk/id/eprint/6481

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