Penicillin resistance and serotype distribution of Streptococcus pneumoniaein Ghanaian children less than six years of age

Abstract

BackgroundThe objective of this study was to determine the prevalence of nasopharyngeal carriage, serotype distribution, and penicillin resistance of Streptococcus pneumoniae in children ≤6 years of age in Ghana.MethodsA cross-sectional study was carried out on a cluster-randomized sample of children ≤6 years of age attending nurseries and kindergartens in Accra and Tamale, Ghana. Basic data on age, sex and exposure to antimicrobials in the previous month were collected on all study subjects. Nasopharyngeal swabs were obtained from participants and all pneumococcal isolates were characterized by serotyping and their penicillin resistance determined.ResultsThe overall prevalence of pneumococcal carriage among the children was 34% in Accra and 31% in Tamale. The predominant serotypes were 19F, 6B, 23F, and 6A with 23% of the isolates being non-typable in Accra and 12% in Tamale. Only two isolates (serotypes 19F and 6B) from Tamale had a MIC >2 μg/ml and were classified as fully penicillin resistant with 45% of the isolates having intermediate resistance.ConclusionsThese findings indicate that the 13-valent pneumococcal conjugate vaccine (PCV-13) recently introduced in Ghana will cover 48% and 51% of the serotypes identified in Accra and Tamale, respectively. The 23-valent pneumococcal polysaccharide vaccine (PPV-23) will cover 54% of all serotypes detected. The two penicillin resistant isolates (MIC 32 μg/ml) were serotypes included in both PCV-13 and PPV-23. A nationwide monitoring system of penicillin susceptibility patterns and pneumococcal serotypes is recommended.

Pneumococcal carriage in rural Gambia prior to the introduction of pneumococcal conjugate vaccine: a population‐based survey

“…Among children under 5 years of age, the proportions of pneumococcal isolates covered by the commercially available PCVs, that is PCV7, PCV10 and PCV13, were 31.5%, 33.9% and 62.7%, while in those aged 18 years and above, these were 20.2%, 25.8% and 42.7%, respectively. This level of PCV coverage in children under 5 years found in this survey is similar with other nasopharyngeal pneumococcal carriage studies conducted in West Africa (Ghana and Senegal) prior to the use of PCV .…”

“…The prevalence estimate of 72% in children under 5 years of age before PCV introduction is similar to that found in the same region of the Gambia among 2‐year‐old children during the PCV9 vaccine trial (82%) and among 4‐year‐olds (69%) in 2005/2006 . The prevalence of carriage was also similar to estimates before vaccine introduction among children under 5 years in Kenya (74%) , but higher prevalence than in Ghana (34%) among children under 6 years , and Senegal (50%) among children under 2 years . We found that the prevalence of carriage decreased with age, and this finding concurs with previous studies .…”

Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines

“…The rates of asymptomatic carriage varied markedly between different age groups in our study, and also the diversity of serotypes displayed age variation. These findings have previously been observed by others [39][40][41]. Young children aged 19-36 months expressed the highest rates of asymptomatic colonization and the widest range of serotypes.…”

Clonal distribution of pneumococcal serotype 19F isolates from Ghana

“…Furthermore, it seems as though the clonal distribution of serotype 19F 47 may be different from what is currently known in Ghana in that many new clones were identified. This 48 supports the importance of continued monitoring of pneumococcal carriage in Ghana and elsewhere 49 when vaccines, e.g., PCV-13, have been introduced to monitor the possible future spread of antimicrobial Ghana (Dayie et al, 2013;Donkor et al 2010 of the country (Dayie et al, 2013). Serotype 19F is a common sero-82 type observed in many countries, and it is also included in the 83 commercially available pneumococcal vaccines (Harboe et al,84 2009; Li et al, 2013;Nathan et al, 2014 Q4 ).…”