Pneumococcal carriage among sickle cell disease patients in Accra, Ghana: Risk factors, serotypes and antibiotic resistance.
Pneumococcal carriage among sickle cell disease patients in Accra, Ghana: Risk factors, serotypes and antibiotic resistance.
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DOI：
10.1371/journal.pone.0206728
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Donkor ES
中科院分区：
文献类型：
--
作者：
Dayie NTKD;Tetteh-Ocloo G;Labi AK;Olayemi E;Slotved HC;Lartey M;Donkor ES
肺炎球菌携带是肺炎球菌疾病发展的前兆，也是该生物体在人与人之间传播的原因。患有镰状细胞病（SCD）的个体更有可能发展为侵袭性疾病。与健康的对应物相比，肺炎患者的疾病表现通常是突然和严重的。在非洲，人们对肺炎球菌与SCD镰状细胞病（SCD）患者的关系知之甚少。本研究的目的是调查SCD患者中肺炎球菌携带的流行病学，包括携带率、危险因素、血清型和抗生素耐药性。这是一项横断面研究，涉及2016年10月至2017年3月从阿克拉的Korle Bu教学医院和玛丽路易斯公主医院招募的402例SCD患者。研究受试者包括202名年龄组的儿童：≤5岁（94）、>5-9岁（75）、≥10-13岁（33）和200名年龄组的成人：14-20岁（46）、21-40岁（112）、41-60岁（25）、≤ 61岁（17）。从研究参与者中收集了鼻咽（NP）拭子以及有关人口统计学、家庭和临床特征的流行病学数据。NP标本进行S. pneumoniae，并通过乳胶凝集法对分离株进行血清分型。药敏试验采用纸片扩散法和E-test法。S.入组研究的儿童和成人SCD患者中肺炎携带率分别为79/202（39.1%; 95% CI：32.3 - 46.2）和20/200（10.0%; 95% CI：6.2 - 15.0）。与肺炎球菌携带相关的危险因素是年龄（OR = 1.137; 95%CI：1.036-1.248; p = 0.007）和流鼻涕（OR = 5.371; 95%CI：1.760-16.390; p = 0.003）。总体而言，从研究参与者中分离出26种肺炎球菌血清型，主要血清型为6 B（10.6%），其次为23 B（8.2%）。在这些儿童中，目前在加纳使用的13价肺炎球菌结合疫苗的血清型覆盖率为32.4%。青霉素耐药率为37.4%（37/99），除1株完全耐药且对头孢曲松敏感外，其余均为中度耐药。对其他抗生素的耐药率从2.5%（左氧氟沙星）到85%（复方新诺明）不等。多重耐药率为34.3%（34/99）。肺炎球菌携带率在SCD儿童中比成人高4倍，其特点是非疫苗血清型占优势，多重耐药水平相当高，尽管青霉素、头孢噻肟和左氧氟沙星的耐药性似乎很低。
Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. Individuals with Sickle Cell Disease (SCD) are more likely to develop invasive disease with S. pneumoniae compared to their healthy counterparts and the presentation of disease in the former is usually abrupt and severe. In Africa, little is known about the pneumococcus in relation to people with SCD Sickle Cell Disease (SCD). The aim of the study was to investigate the epidemiology of pneumococcal carriage among SCD patients including the carriage prevalence, risk factors, serotypes and antibiotic resistance. This was a cross sectional study involving 402 SCD patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from October 2016 to March 2017. The study subjects included 202 children of the age groups: ≤5 years (94), >5–9 years (75), ≥10–13 years (33) and 200 adults of the age groups: 14–20 years (46), 21–40 years (112), 41–60 years (25), ≤ 61 years (17). Nasopharyngeal (NP) swabs were collected from the study participants as well as epidemiological data on demographic, household and clinical features. The NP specimens were cultured for S. pneumoniae and the isolates were serotyped by latex agglutination. Antimicrobial susceptibility tests of the isolates were done by the disc diffusion test and E-test. Prevalence of S. pneumoniae carriage among children and adult SCD patients enrolled in the study were 79/202 (39.1%; 95% CI: 32.3 to 46.2) and 20/200 (10.0%; 95% CI: 6.2 to 15.0) respectively. Risk factors associated with pneumococcal carriage were age (OR = 1.137; 95% CI: 1.036–1.248; p = 0.007) and runny nose (OR = 5.371; 95% CI: 1.760–16.390; p = 0.003). Overall, twenty-six pneumococcal serotypes were isolated from the study participants and the predominant serotype was 6B (10.6%), followed by 23B (8.2%). Among the children, serotype coverage of the 13-valent Pneumococcal Conjugate Vaccine, which is currently used in Ghana was 32.4%. Prevalence of penicillin resistance among the pneumococcal isolates was 37.4% (37/99) and all the penicillin-resistant isolates exhibited intermediate penicillin resistance with the exception of one isolate that showed full resistance and was susceptible to ceftriaxone. Prevalence of resistance to the other antibiotics ranged from 2.5% (levofloxacin) to 85% (cotrimoxazole). Multidrug resistance occurred among 34.3% (34/99) of the pneumococcal isolates. Pneumococcal carriage was four-fold higher in SCD children than adults and was characterized by predominance of non-vaccine serotypes and considerable level of multidrug resistance, though penicillin, cefotaxime and levofloxacin resistance appeared to be very low.
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影响因子：
3.7
作者：
Donkor ES;Adegbola RA;Wren BW;Antonio M
通讯作者：
Antonio M
西澳大利亚原住民中肺炎球菌携带的预测因素以及 13 价肺炎球菌结合疫苗接种的效果。
DOI：
10.1186/s41479-017-0038-x
发表时间：
2017
期刊：
Pneumonia (Nathan Qld.)
影响因子：
--
作者：
Collins DA;Hoskins A;Snelling T;Senasinghe K;Bowman J;Stemberger NA;Leach AJ;Lehmann D
通讯作者：
Lehmann D
影响因子：
5.1
作者：
ANGLIN, DL;SIEGEL, JD;BUCHANAN, GR
通讯作者：
BUCHANAN, GR
影响因子：
2
作者：
Boadu, Isaac;Ohemeng, Agartha;Renner, Lorna Awo
通讯作者：
Renner, Lorna Awo
影响因子：
3.6
作者：
Abdullahi, Osman;Ayiro, Joyce;Scott, J. Anthony G.
通讯作者：
Scott, J. Anthony G.