Abstract
Objective: The aim of this study was to analyze the NP/OP S. pneumoniae serotype distribution and potential vaccine coverage in Costa Rican children with Otitis Media (OM) before the introduction of PCV-7 in the National Immunization Program (NIP). Methods: Between 2002 and 2006, NP and OP samples were obtained from 641 children from 6 to 79 months of age, at the time of OM diagnosis. S. pneumoniae serotyping and antimicrobial susceptibility were performed. Results: 386 S. pneumoniae isolates were recovered. The most common S. pneumoniae serotypes (ST) were: ST 6B, ST 14, ST 19F. Penicillin non-susceptibility was observed among 57% of the isolates obtained from children Conclusions: S. pneumoniae was isolated from the NP and/or OP in the majority (59%) of studied children with OM. At a statistical significant level, only serotype 3 was more frequently isolated among children >24 months of age. Antibiotic non-susceptibility and MDR were significantly higher in children
Highlights
Streptococcus pneumoniae is a major cause of morbidity and mortality in children, especially in those younger than 5 years of age living in developing countries [1,2,3]
S. pneumoniae isolates with an minimal inhibitory concentration (MIC) ≤ 0.06 mg/L were considered susceptible to penicillin; isolates with a MIC value between 0.125 mg/L and 1.0 mg/L were considered intermediate to penicillin and those with a MIC value ≥ 2.0 mg/L were defined as penicillin resistant
Among the 386 positive NP or OP samples, 229 (59%) samples were obtained among children ≤ 24 months of age and 157 (41%) samples were from children > than 24 months of age (P < 0.001)
Summary
Streptococcus pneumoniae is a major cause of morbidity and mortality in children, especially in those younger than 5 years of age living in developing countries [1,2,3]. Several studies conducted in Israel [6], South Africa [7], Pakistan [8] and Brazil [9] confirm that nasopharyngeal colonization with S. pneumoniae in young children may predict the serotype distribution and antimicrobial susceptibility of the strains producing invasive disease. Our main objectives in this study were 1) to analyze the prevalence and serotype distribution of S. pneumoniae NP and/or OP colonization among Costa Rican children from 6 to 79 months of age, with OM before the introduction of PCV-7 in the NIP of Costa Rica; 2) analyze the antimicrobial susceptibility patterns among the recovered NP and OP S. pneumoniae serotypes isolated; and 3) calculate the potential vaccine coverage against the isolated serotypes with the three currently available PCVs in Latin America (PCV-7, PCV-10 and PCV-13)
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