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Epidemiological study of Streptococcus pneumoniae carriers in healthy primary-school children
Insights
This study found that 36% of Spanish children carry Streptococcus pneumoniae, with high resistance to common antibiotics like penicillin. Previous antibiotic use and young siblings were linked to carriage.
Area of Science:
- Pediatrics
- Microbiology
- Public Health
Background:
- Streptococcus pneumoniae carriage is a significant public health concern, particularly in pediatric populations.
- Understanding carriage prevalence and antimicrobial resistance patterns is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the carrier state of Streptococcus pneumoniae in healthy 6-year-old children in northern Spain.
- To determine the serotype distribution and antimicrobial resistance profiles of carried S. pneumoniae strains.
Main Methods:
- A cross-sectional study screening 332 healthy 6-year-old children from nine primary schools.
- Bacteriological culture, serotyping, and antimicrobial susceptibility testing (AST) were performed.
- Strain identification was confirmed using hybridization, pneumolysin-mediated agglutination, and mouse pathogenicity tests.
Main Results:
- 36% of children carried S. pneumoniae (128 strains identified).
- High rates of antibiotic resistance were observed: 64% resistant to penicillin, >40% to trimethoprim-sulfamethoxazole, tetracycline, and erythromycin.
- Penicillin-resistant strains showed co-resistance to cefotaxime (22%); erythromycin-resistant strains had some susceptibility to clindamycin (20%).
- Previous antibiotic administration and having siblings under 2 years old correlated with pneumococcal carriage.
Conclusions:
- A substantial proportion of Spanish children carry Streptococcus pneumoniae, exhibiting significant antimicrobial resistance.
- Serotypes 19, 23, 3, 24, and 11 were most frequent among typed strains.
- Findings highlight the need for monitoring antibiotic resistance in pediatric S. pneumoniae isolates and inform vaccination strategies.
Abstract:
To obtain information on the Streptococcus pneumoniae carrier state in Spanish children, 332 healthy 6-year-old children from nine primary schools in northern Spain were screened. Thirty-six percent of the children had positive cultures yielding 128 strains. Seventy-one strains belonged to 14 serogroup/serotypes, the most frequent being 19, 23, 3, 24 and 11. Fifty-seven strains were nontypeable. The identification of strains with equivocal results was confirmed at species level by means of hybridisation with a specific probe, pneumolysin-mediated agglutination and a pathogenicity test in mice. Sixty-four percent of strains showed resistance to penicillin, 22% of these also being resistant to cefotaxime. More than 40% of the strains were resistant to trimethoprim-sulfamethoxazole, tetracycline and erythromycin. Twenty percent of the erythromycin-resistant strains were susceptible to clindamycin. Two strains were resistant to rifampicin and one strain was resistant to ofloxacin. All strains were susceptible to vancomycin. Previous antibiotic administration and having siblings under the age of 2 years correlated with the carriage of pneumococcus. There was no correlation with the carriage of antibiotic-resistant strains, or a record of previous infections, previous hospital admissions or having relatives with chronic respiratory disease.