Nasopharyngeal Carriage and Antibiogram of Pneumococcal and Other Bacterial Pathogens from Children with Sickle Cell Disease in Tanzania.
Nasopharyngeal Carriage and Antibiogram of Pneumococcal and Other Bacterial Pathogens from Children with Sickle Cell Disease in Tanzania.
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坦桑尼亚镰状细胞病儿童的肺炎球菌和其他细菌病原体的鼻咽携带和抗菌谱。
DOI：
10.2147/idr.s367873
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发表时间：
2022
影响因子：
3.9
通讯作者：
Kamuhabwa, Appolinary A. R.
中科院分区：
文献类型：
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作者：
Mutagonda, Ritah F.;Bwire, George;Sangeda, Raphael Zozimus;Kilonzi, Manase;Mlyuka, Hamu;Ndunguru, Joyce;Jonathan, Agnes;Makani, Julie;Minja, Irene Kida;Ruggajo, Paschal;Balandya, Emmanuel;Kamuhabwa, Appolinary A. R.
细菌感染在镰状细胞病（SCD）患者，尤其是5岁以下儿童的发病和死亡中起着重要作用。在坦桑尼亚，针对SCD患儿的肺炎球菌感染预防措施主张同时使用口服青霉素V（PV）和肺炎球菌疫苗（PNV）。因此，本研究旨在调查坦桑尼亚SCD患儿鼻咽部肺炎链球菌（肺炎双球菌）和金黄色葡萄球菌的携带情况及抗菌谱。
这项横断面研究在坦桑尼亚达累斯萨拉姆的两个泛非镰状细胞病研究联盟（SPARCO）研究点开展。研究为期6个月，招募了6至59个月大的SCD患儿。使用半结构化问卷收集患者数据。从所有参与者处采集鼻咽拭子，培养肺炎链球菌及其他细菌分离株。采用纸片扩散法对分离株进行药敏试验。
在204名参与者中，细菌携带总体患病率为53.4%，其中常见的分离菌为金黄色葡萄球菌（23.5%）、凝固酶阴性葡萄球菌（CoNS）（23%）和肺炎链球菌（7.8%）。在药敏试验中，金黄色葡萄球菌分离株对青霉素的耐药性最高（81.8%），而81.3%的肺炎链球菌分离株对复方新诺明耐药。金黄色葡萄球菌和肺炎链球菌分离株对氯霉素的耐药性最低（分别为6.3%和0%）。金黄色葡萄球菌分离株的多重耐药（MDR）比例为66.7%，肺炎链球菌分离株为25%。
在坦桑尼亚达累斯萨拉姆，SCD患儿鼻咽部携带致病菌的比例相当高。对常用抗生素存在多重耐药菌株，这表明有必要重新考虑优化SCD患儿的抗菌预防措施，并倡导接种肺炎球菌疫苗。
Bacterial infections contribute significantly to morbidity and mortality in sickle cell disease (SCD) patients, particularly children under five years of age. In Tanzania, prophylaxis against pneumococcal infection among children with SCD advocates the use of both oral penicillin V (PV) and pneumococcal vaccines (PNV). Therefore, this study aimed to investigate nasopharyngeal carriage and antibiogram of Streptococcal pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) in children with SCD in Tanzania. This cross-sectional study was undertaken at the two Sickle Pan-African Research Consortium (SPARCO) study sites in Dar es salaam, Tanzania. The study was conducted for six months and enrolled children with SCD between the ages of 6 to 59-months. A semi-structured questionnaire was used to collect patient data. Nasopharyngeal swabs were collected from all participants and cultured for Streptococcal pneumoniae and other bacterial isolates. Antimicrobial susceptibility tests of the isolates were done using the disc diffusion method. Out of 204 participants, the overall prevalence of bacterial carriage was 53.4%, with S. aureus (23.5%), coagulase-negative Staphylococci (CoNS) (23%) and S. pneumoniae (7.8%) being commonly isolated. In antibiotic susceptibility testing, S. aureus isolates were most resistant to penicillin (81.8%), whereas 81.3% of S. pneumoniae isolates were resistant to co-trimoxazole. The least antimicrobial resistance was observed for chloramphenicol for both S. aureus and S. pneumoniae isolates (6.3% versus 0%). The proportion of multi-drug resistance (MDR) was 66.7% for S. aureus isolates and 25% for S. pneumoniae isolates. There are substantially high nasopharyngeal carriage pathogenic bacteria in children with SCD in Dar es Salaam, Tanzania. The presence of MDR strains to the commonly used antibiotics suggests the need to reconsider optimizing antimicrobial prophylaxis in children with SCD and advocacy on pneumococcal vaccines.