Carriage rates and antimicrobial sensitivity of pneumococci in the upper respiratory tract of children less than ten years old, in a north Indian rural community

PLoS One. 2021 Feb 4;16(2):e0246522. doi: 10.1371/journal.pone.0246522. eCollection 2021.

Abstract

Pneumococcal carriage studies are important for vaccine introduction and treatment strategies. Pneumococcal carriage rates estimated in this cohort study among children in a rural community of northern India. Between August 2012 and August 2014, trained nurses made weekly home visits to screen enrolled children aged <10 years for acute upper or lower respiratory infections (AURI/ALRI) in Ballabgarh, Haryana. Nasal swab from infants aged <1year and throat swab from children aged ≥1 year were collected. All specimens were cultured for pneumococci; isolates were serotyped and subjected to antimicrobial susceptibility testing. During the study period, 4348 nasal/throat swabs collected from children with clinical features of ARI (836 ALRI, 2492 AURI) and from 1020 asymptomatic children. Overall pneumococcal carriage was 5.1%, the highest carriage rate among children <1 year of age (22.6%). The detection rates were higher among children with ARI (5.6%; 95% CI: 4.8-6.4) than asymptomatic children (3.3%; 95% CI: 2.3-4.6). Among 220 pneumococcal isolates, 42 diverse serotypes were identified, with 6B/C (8.6%), 19A (7.2%), 19F (6.8%), 23F (6.4%), 35A/B/C (6.4%), 15B (5%), 14 (4.5%) and 11A/C/D (3.2%) accounting for 50%. Forty-five percent of the serotypes identified are included in the current formulation of 13-valent pneumococcal conjugate vaccine. Ninety-six percent of isolates were resistant to co-trimoxazole, 9% were resistant to erythromycin, and 10% had intermediate resistance to penicillin with minimum inhibitory concentration ranges (0.125 to 1.5 μg/ml). Pneumococcal detection was relatively low among children in our study community but demonstrated a diverse range of serotypes and half of these serotypes would be covered by the current formulation of 13-valent pneumococcal vaccine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Pneumococcal Infections / microbiology
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines / therapeutic use
  • Rural Population
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / pathogenicity*

Substances

  • 13-valent pneumococcal vaccine
  • Anti-Bacterial Agents
  • Pneumococcal Vaccines