Microbiological aetiology of paediatric respiratory tract infections in Kyrgyzstan
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Nargiza Osmonbaeva1, Joakim Bloch2,3, Aidai Erkinbaeva1
1National Centre of Cardiology and Internal Medicine Named After Academician M. Mirrakhimov, Bishkek, Kyrgyzstan.
Insights
This study in Kyrgyzstan found high rates of viral and bacterial respiratory tract infections (RTIs) in children. Findings can guide local antibiotic use and improve child health outcomes.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Public health
Background:
- Respiratory tract infections (RTIs) are a major global cause of child morbidity and mortality.
- Kyrgyzstan faces high under-five mortality from lower RTIs and significant antibiotic overuse.
- No prior systematic data on RTI etiologies existed for Kyrgyzstan.
Purpose of the Study:
- To identify the causative agents of RTIs in Kyrgyz children.
- To assess pneumococcal conjugate vaccine (PCV) vaccination rates.
- To investigate the correlation between PCV status and Streptococcus pneumoniae detection.
Main Methods:
- Collected samples from 6-month to 12-year-old children with acute RTIs (outpatients) or pneumonia (inpatients) from Nov 2022 to June 2023.
- Utilized standard culture and real-time polymerase chain reaction (RT-PCR) for pathogen identification.
- Gathered vaccination status via records and parental recall.
Main Results:
- S. pneumoniae was the most common bacterial pathogen (44.8% of cultured bacteria).
- Viral pathogens were detected in 64.1% of outpatients and 54.7% of inpatients.
- Mycoplasma pneumoniae possibly epidemic in Spring 2023 (15.8% of inpatients); ~20% had viral-bacterial co-detections. PCV vaccination rates were high (87.1% outpatients, 75.9% inpatients), with lower rates in unvaccinated children under five and higher S. pneumoniae carriage in unvaccinated inpatients.
Conclusions:
- High prevalence of viral infections and co-detections in Kyrgyz children with RTIs.
- Findings can inform clinical guidelines for local healthcare providers.
- Potential for more targeted antibiotic use and improved pediatric health outcomes in Kyrgyzstan.
Introduction:
Respiratory tract infections (RTIs) are a leading cause of morbidity and mortality in children worldwide. Aetiologic virus and bacteria vary geographically. To date, no systematic data on RTI aetiologies have been published from Kyrgyzstan, a country with a high under-five mortality from lower RTIs and a widespread overuse of antibiotics. We aimed to identify the aetiologies of RTI in children in Kyrgyzstan and to assess the pneumococcal conjugate vaccine (PCV) vaccination rate and the correlation with the detection of Streptococcus pneumoniae in our population.
Methods:
We collected samples from children aged 6 months to 12 years presenting with symptoms of acute RTI for outpatients or diagnosed with pneumonia for inpatients. Samples were collected from November 2022 to June 2023 and were analysed using standard culture methods and real-time polymerase chain reaction (RT-PCR) to identify bacterial, viral, and atypical bacterial pathogens. We obtained the vaccination status through vaccination records and parents' recollections.
Results:
Positive bacteriologic cultures were found for 294 (25.0%) of 1174 outpatients and 83 (27.7%) of 300 inpatients. S. pneumoniae was the most commonly found bacterial pathogen in both groups, making up 44.8% of all cultured bacteria. Furthermore, 445 (64.1%) of 694 outpatients with RT-PCR performed had one or more viral pathogens identified, while this was the case for 162 (54.7%) of 296 inpatients. Mycoplasma pneumoniae was identified in 15.8% of inpatients possibly representing an epidemic in the spring of 2023. Approximately 20% of both in- and outpatients had a viral-bacterial simultaneous detection. 87.1% of outpatients and 75.9% of inpatients had been vaccinated with PCV. We found a higher proportion of unvaccinated children among those under five years of age and a higher carriage rate of S. pneumoniae among unvaccinated inpatients.
Conclusion:
In this study, we found a high prevalence of viral infections and viral-bacterial simultaneous detections among Kyrgyz children with respiratory tract infections (RTI). The findings from this study can inform new clinical guidelines for local health workers and lead to more targeted use of antibiotics and improved health outcomes for children in Kyrgyzstan.
Clinical Trial:
Not applicable.
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