Abstract
Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.
Highlights
The aim of this study was to provide baseline information on the prevalence of nasopharyngeal pneumococcal carriage, serotypes and antimicrobial susceptibility patterns of these pneumococci in Human Immunodeficiency Virus (HIV) infected children in Nairobi prior to the inclusion of pneumococcal conjugate vaccine to the routine childhood immunization programme in Kenya
We found that the presence of siblings under 5 years was a risk factor (p = 0.001; odds ratio, 3.027; 95% confidence interval 1.535 to 5.97) contributing to nasopharyngeal S. pneumoniae carriage
Serotype 19F which is a PCV7 and PHiD-CV10 (SynflorixTM) vaccine serotype, ranked third in the nasopharyngeal isolates and constituted 14.8% of all the isolates. This is lower compared to PCV-7 (26%) and PHiD-CV10 (26%) vaccine serotypes isolated from Aboriginal children in Australia [8]
Summary
The aim of this study was to provide baseline information on the prevalence of nasopharyngeal pneumococcal carriage, serotypes and antimicrobial susceptibility patterns of these pneumococci in HIV infected children in Nairobi prior to the inclusion of pneumococcal conjugate vaccine to the routine childhood immunization programme in Kenya. The collection of nasopharyngeal swabs helps to monitor the circulating serotypes and emergence of new drug resistant strains in Nairobi community prior introduction of the new pneumococcal vaccine (SynflorixTM). This in turn enables us to predict the antimicrobial resistance patterns and the likely effectiveness of the pneumococcal vaccine. Most of the S. pneumoniae isolates were non pneumococcal vaccine isolates
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