Pneumococcal colonization among healthy and hospitalized vaccine-naive Sri Lankan children

Vidanapathirana, Gihani; Angulmaduwa, Sacheera; Munasinghe, Tissa; Ekanayake, Asela; Kudagammana, Thushara; Dissanayaka, N. L. A.; Liyanapathirana, Veranja

doi:10.1016/j.vaccine.2020.09.040

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…The resistance to macrolides was higher in our study than previous Yemeni reports [29,46], but consistent with findings in the Middle East and other developing countries [17,47,48]. The resistance profile of pneumococci against doxycycline was consistent with that established in low and middle-income countries [47].…”

Section: Discussionsupporting

confidence: 92%

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine

Matran,

Al-Haddad,

Kour

et al. 2024

J Infect Dev Ctries

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Introduction: Streptococcus pneumoniae cause a significant global health challenge. We aimed to determine nasopharyngeal carriage, serotypes distribution, and antimicrobial profile of pneumococci among the children of Aden. Methodology: A total of 385 children, aged 2-17 years, were included. Asymptomatic samples were randomly collected from children in selected schools and vaccination centers. Symptomatic samples were obtained from selected pediatric clinics. The nasopharyngeal swabs were tested for pneumococci using culture and real time polymerase chain reaction (RT-PCR). Serotyping was done with a pneumotest-latex kit and antimicrobial susceptibility was tested by disc diffusion and Epsilometer test. Results: The total pneumococcal carriage was 44.4% and 57.1% by culture and RT-PCR, respectively. There was a statistically significant association between carriage rate and living in single room (OR = 7.9; p = 0.00001), sharing a sleeping space (OR = 15.1; p = 0.00001), and low monthly income (OR = 2.02; p = 0.007). The common serotypes were 19, 1, 4, 5, 2, and 23. The proportion of non-pneumococcal conjugate vaccine (non-PCV13) serotypes was 24%. Pneumococci were resistant to penicillin (96.5%), cefepime (15.8%), ceftriaxone (16.4%), and amoxicillin-clavulanate (0%). Erythromycin, azithromycin, and doxycycline had resistance rates of 48%, 31%, and 53.3%, respectively. Conclusions: A high pneumococcal carriage rate was observed in Yemeni children, particularly in low-income households and shared living conditions. There was significant penicillin resistance at meningitis breakpoint. Furthermore, non-PCV13 serotypes were gradually replacing PCV13 serotypes. The findings underscore the urgent need for enhanced surveillance and stewardship to improve vaccination and antibiotic policies in Yemen.

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Section: Discussionsupporting

confidence: 92%

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine

Matran,

Al-Haddad,

Kour

et al. 2024

J Infect Dev Ctries

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“…According to a study in Sri Lanka as part of a global S. pneumoniae research network in 2005–2007, erythromycin resistance in S. pneumoniae in Sri Lanka was 60.7 % [ 38 ]. This has increased to 82.1 % (147/179) in hospitalized children with respiratory symptoms [ 39 ]. The wide use of macrolides is of substantial concern, with reported resistance of such a significant magnitude [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

A study on viruses and bacteria with particular interest on Mycoplasma pneumoniae in children with exacerbation of asthma from a tertiary care hospital in Sri Lanka

Wijesooriya,

Chalker,

Perera

et al. 2024

Access Microbiology

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Asthma is a significant public health concern, particularly in children with severe symptoms. Exacerbation of asthma (EOA) is life-threatening, and respiratory infections (RIs) play a crucial role. Though viruses play a significant role in EOA, patients are empirically treated with antibiotics, contributing to antibiotic resistance development. Although there are widely reported associations of EOA with viral or Mycoplasma pneumoniae infections, there are no published data for Sri Lanka. The present study aimed to identify the association of common respiratory viruses, typical respiratory bacterial pathogens and M. pneumoniae in children with EOA and relate them with the compatibility of antimicrobial use. A case-control study was conducted in the paediatric unit of North Colombo Teaching Hospital, Sri Lanka, involving two groups of children between 5 and 15 years of age. Group 1 is children with EOA and Group 2 is children with stable asthma (SA). Each group consisted of 100 children. Sputum/throat swabs were tested for common respiratory viruses using virus-specific fluorescein isothiocyanate-labelled monoclonal antibodies (MAbs), bacteria by routine culture, and M. pneumoniae by real-time polymerase chain reaction. Macrolide resistance in M. pneumoniae was detected using conventional PCR and sequencing specific genetic mutations in the 23S rRNA gene. M. pneumoniae was genotyped using nested multilocus sequence typing, which targeted eight housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC and adk). There was no significant difference in age, gender, demographic or geographical location between the two groups. In children with EOA, antibiotics were used in 66 % (66/100) and macrolides in 42 % (42/100). Samples comprised 78 % (78/100) sputum and 22 % (22/100) throat swabs. Adenovirus was the most common virus identified, and it was significantly higher in children with EOA compared to those with SA. Still, the two groups had no significant difference in typical bacteria findings. M. pneumoniae was detected in one patient with EOA, but none was detected in the SA group. The M. pneumoniae was macrolide-sensitive and ST14 by multilocus sequence typing. This study showed that the empiric use of antibiotics in children with asthma might be better targeted with prior pathogen screening to inform appropriate treatment to minimize antibiotic resistance.

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“…There are only a few Sri Lankan studies done on pneumococcal serotypes which have been done on invasive isolates and respiratory colonization. 8,10,11 Scarcity of data on serotypes, especially on colonizing flora is a gap in local knowledge.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae - an uncommon cause of neonatal sepsis: two case reports

Gunasekera

Gunaratna

Sathanantharajah

et al. 2022

Sri Lankan J Infec Dis

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Pneumococcal colonization among healthy and hospitalized vaccine-naive Sri Lankan children

Cited by 5 publications

References 31 publications

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine

Streptococcus pneumoniae among the children of Aden, Yemen: a cross-sectional report of post-pneumococcal conjugate vaccine

A study on viruses and bacteria with particular interest on Mycoplasma pneumoniae in children with exacerbation of asthma from a tertiary care hospital in Sri Lanka

Streptococcus pneumoniae - an uncommon cause of neonatal sepsis: two case reports

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