Unravelling the ecology of antibiotic resistant bacteria in the nasopharynx

To study the dynamics and diversity of pneumococcal carriage and antibiotic resistance, a more thorough and systematic approach has been employed compared with routine surveillance of serotype and anti-biotic resistance. Up to ten pneumococcal isolates from pernasal (nose) and oropharyngeal (throat) sites are isolated and characterised. Our carriage studies have revealed a diverse community of pneumococci with multiple strains colonising the nasopharynx of children. In Tanzanian children less than 6 years of age, up to six serotypes and up to six different antibiotic sensitivities (as distinguished by at least a fourfold difference in the minimum inhibitory concentration) have been found. Serotyping by the Quelling reaction is prone to inaccuracy and requires expensive serological reagents. To improve the accuracy and reduce the costs, an alternative capsular typing DNA-based method has been developed. This chapter will describe the methods we have employed with emphasis on the capsular typing method.