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Abstract
Nasopharyngeal carriage of Streptococcus pneumoniae is found to play an important role in the development and transmission of pneumococcal diseases. In this study, we assessed the nasopharyngeal carriage, antimicrobial susceptibility patterns and associated risk factors of S. pneumoniae among children under five. A total of 361 children under five attending the outpatient department of Shanan Gibe Hospital in Jimma, Southwest Ethiopia were enrolled from June to September 2014. Nasopharyngeal specimens were collected using sterile plastic applicator rayon tipped swab and inoculated on tryptone soy agar supplemented with 5% sheep blood and 5 µg/mL gentamycin. Antimicrobial susceptibility testing was performed using the modified disk diffusion method. The overall prevalence of S. pneumoniae carriage was 43.8% (158/361) among children under five. Resistance to tetracycline, cotrimoxazole, penicillin, chloramphenicol and erythromycin was observed in 53.2% (84/158), 43.7% (69/158), 36.1% (57/158), 13.3% (21/158) and 8.9% (14/158) of isolates respectively. Multidrug resistance was seen in 17.7% (28/158) of isolates. In multivariate logistic regression analysis, children living with sibling(s) < 5 years old (adjusted odds ratio (AOR) = 1.798; 95% confidence interval (CI), 1.169–2.766) and malnutrition (AOR = 2.065; 95% CI, 1.239–3.443) were significantly associated with S. pneumoniae carriage. A high nasopharyngeal carriage of S. pneumoniae was observed among children under five in Southwest Ethiopia. There should be a strategy to prevent S. pneumoniae nasopharyngeal colonization and identify the appropriate antibiotic to the individual child.
Highlights
IntroductionStreptococcus pneumoniae (pneumococcus) is a major cause of childhood morbidity and mortality worldwide, in lower income countries [1,2]
Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide, in lower income countries [1,2]
We found two factors associated with the increased risk of S. pneumoniae in children under five, i.e., living with sibling(s) < 5 years old and malnutrition
Summary
Streptococcus pneumoniae (pneumococcus) is a major cause of childhood morbidity and mortality worldwide, in lower income countries [1,2]. S. pneumoniae is the most significant cause of bacterial pneumonia deaths and accounted for 33% of such deaths in 2010 in children under five years of age [5]. S. pneumoniae is the leading cause of pneumonia and the largest single infectious killer of children in Ethiopia [7]. In Ethiopia pneumococcal conjugate vaccine (PCV-10) has been introduced into the routine child immunization program since 2011. This is given to young children with the recommended three dose schedules at 6, 10 and 14 weeks of children age. Despite the introduction of PCV-10 for majority of children in Ethiopia, S. pneumoniae remains the major causes of mortality in under-fives, accounting for 21% of mortality in this group [9]
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