Percentage, Bacterial Etiology and Antibiotic Susceptibility of Acute Respiratory Infection and Pneumonia among Children in Rural Senegal

Abstract

Acute respiratory infections (ARI) are still a major health problem in most developing countries. So far no study has evaluated the importance of childhood ARI in rural Senegal. We prospectively studied ARI, the percentage of pneumonia and related mortality, as well as the bacterial composition of nasopharyngeal flora using nasopharyngeal aspirates in 114 children, aged 2-59 months, presenting at Ndioum's pediatric ward. Excluded from the trial were those children that had had antimicrobial therapy in the previous 2 weeks. The Kirby-Bauer method was used to determine antibiotic resistance throughout the study. The percentage of ARI and pneumonia among the population tested was 24 per cent and 11 per cent respectively. Streptococcus pneumonia was often resistant to cotrimoxazole (31 per cent) but only 9 per cent were resistant to chloramphenicol and 14 per cent to penicillin. Haemophilus influenzae (HI) was uniformly sensitive to ampicillin, and only 4 per cent were resistant to chloramphenicol and 11 per cent to cotrimoxazole. We conclude that SP and HI resistance to cotrimoxazole is important and warrants larger clinical trials using chloramphenicol. Information campaigns and intense management of comorbidities are desirable in this type of population. Comorbidities (tuberculosis, malaria, HIV-AIDS, severe malnutrition) are determinant variables in many ARI cases and carry a high negative prognosis value.

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

“…In 21 studies 14,17,20,23,27,30,31,37,38,43,44,52–59,61,62 representing 11,486 isolates (of which 82.0% were from Southern Africa) 23,57,62 , the pooled prevalence of penicillin susceptibility was 78.1% (95% CI 61.9, 89.2). The change in minimum inhibitory concentration breakpoints instituted by CLSI in 2008 14,20,30,31,37,38,53–55,57,59,61,63 yielded susceptibilities of 82.5% (95% CI 60.7, 94.1) pre-CLSI 14,17,20,30,31,37,38,53–55,57,59,61 and 69.0% (95% CI 42.6, 88.4) post-CLSI. 23,43,52,56,58,62 Overall susceptibilities to beta-lactam antibiotics were high: ampicillin/amoxicillin 94.7% (95% CI 80.2, 99.4) 17,30,38,42,43,54,55,57,59,60 and third-generation cephalosporins 98.5% (95% CI 95.1, 100.0).…”

“…However, penicillin susceptibility was lower among invasive isolates in Northern (33.3–44.5%) 27,37 and Eastern Africa (16.7–35.3%). 30,58 Pooled susceptibilities were 90.8% (95% CI 80.6, 96.4) for chloramphenicol 17,19,20,30,38,52–55,57–60 and 94.0% (95% CI 79.4, 99.6) for azithromycin/erythromycin, 17,31,38,56,58,60,61 but substantially lower for trimethoprim-sulfamethoxazole (31.7% [95% CI 9.8, 61.8]), 17,20,31,53–56,58,60 and tetracycline (51.0% [95% CI 36.4, 65.0]; Figure 5 and Appendix Figure 2), 17,38,54,55,58 each of which is in common use in Africa.…”

Do Children with Uncomplicated Severe Acute Malnutrition Need Antibiotics? A Systematic Review and Meta-Analysis

“…The prevalence of clinical infections by syndromes were analysed with regards to the age, country, the HIV prevalence, and the mortality, and subdivided in 2 groups: Table 3 shows 16 studies of only SAM children [34], [38], [39], [40], [44]–[56], and eight studies of children with not only SAM (Mixed-NUT) [37], [41], [57], [58], [59], [60], [61], where percentage of SAM was included. A total of 21,977 children were included.…”

Point Mutations in thefolPGene Partly Explain Sulfonamide Resistance ofStreptococcus mutans

“…Although dental caries is not usually treated by antibiotics, the VSG have attracted interest due to their potential to act as reservoirs of resistance to antibiotic determinants [3]. Additionally, in individuals taking antibiotics as prophylaxis, resistance of commensals to antibiotic determinants could be selected [4] and transferred to pathogenic organisms [5] such as Streptococcus pneumoniae which kills over 1,000,000 children worldwide every year [4]. …”