IngentaConnect Pneumococcal nasopharyngeal carriage and patterns of penicillin r...

Authors: Russell, F.M.¹; Carapetis, J.R.²; Ketaiwai, S.³; Kunabuli, V.³; Taoi, M.³; Biribo, S.⁴; Seduadua, A.; Mulholland, E.K.⁵

Source: Annals of Tropical Paediatrics: International Child Health, Volume 26, Number 3, September 2006 , pp. 187-197(11)

Publisher: Maney Publishing

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.

Document Type: Research article

DOI: 10.1179/146532806X120273

Affiliations: 1: Centre for International Child Health, Department of Paediatrics, University of Melbourne, Melbourne, Australia 2: Centre for International Child Health, Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia 3: Fiji Pneumococcal Project, Fiji School of Medicine, Suva, Fiji 4: Department of Microbiology, Fiji School of Medicine, Suva, Fiji 5: Centre for International Child Health, Department of Paediatrics, University of Melbourne, Melbourne, Australia; London School of Hygiene and Tropical Medicine

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$51.00 plus tax Refund Policy

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