High Rates of Colonization with Drug Resistant Hemophilus Influenzae Type B and Streptococccus Pneumoniae in Unvaccinated HIV Infected Children from West Bengal
High Rates of Colonization with Drug Resistant Hemophilus Influenzae Type B and Streptococccus Pneumoniae in Unvaccinated HIV Infected Children from West Bengal
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DOI：
10.1007/s12098-010-0310-z
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发表时间：
2011-04-01
影响因子：
4.3
通讯作者：
Mandal, Sutapa
中科院分区：
文献类型：
--
作者：
Das Bhattacharya, Sangeeta;Niyogi, Swapan Kumar;Mandal, Sutapa
To determine nasopharyngeal colonization rates of two vaccine preventable bacterial pathogens Hemophilus influenzae type b (Hib), and Streptococcus pneumoniae (Pneumococcus), antibiotic susceptibility of isolates, factors associated with their colonization, and immunization history in a cohort of HIV infected children.The authors conducted a cross-sectional nasopharyngeal swab survey of 151 children affected with HIV presenting for routine outpatient care in West Bengal, India.151 HIV affected children were enrolled. The median age was 6, 148/151 children were HIV positive, 65% had moderate to severe malnutrition, 53% were moderately to severely immunosuppressed, 17% were on antiretroviral therapy (ART), 90% were on cotrimoxazole prophylaxis (TMP/SMX). None had received the pneumococcal or Hib conjugate vaccines. Hib prevalence was 13% and pneumococcal prevalence was 28%. Children with normal or moderate immune suppression had high rates of colonization compared to those with severe immunosuppression (71% Hib, 61% pneumococcus). Hib and pneumococcal isolates had high rates of resistance to tested antibiotics including TMP/SMX and third generation cephalosporins. Neither ART nor TMP/SMX prevented colonization. Children colonized with multidrug resistant isolates had high rates of exposure to TMP/SMX.HIV infection, late access to ART, high rates of colonization to resistant organisms and lack of access to vaccines makes this population vulnerable to invasive disease from Hib and pneumococcus.
