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NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN ORPHANS, PRESCHOOL CHILDREN AND UNORGANIZED CHILDREN UNDER 5 YEARS

https://doi.org/10.15690/vsp.v14i2.1293

Abstract

Nasopharyngeal colonization with Streptococcus pneumoniae is a source of respiratory mucosal and invasive infections. For effective vaccine prophylaxis of these diseases the national monitoring of the circulating serotypes and antimicrobial resistance of Streptococcus pneumoniae is required. Objective: To analyze serotype diversity and antimicrobial resistance of S. pneumoniae in the nasopharyngeal carriage in children under 5 years. Methods and patients: The study included orphanage, nursery and children not attending preschool institutions (unorganized children) without respiratory infections and not receiving antibiotic therapy. Conducted microbiological analysis of nasopharyngeal flora, serotyping of pneumococcus, assess their sensitivity to antibiotics. Results: Nasopharyngeal carriage of S. pneumoniae was found in 23%, Moraxella catarrhalis - in 23%, Haemophilus influenzae - 16% of the 246 children included in the study. Serotype was determined in 54 pneumococcal isolates: predominant serotypes 19F (21%), 6B (15%), 23F (14%), 14 (8%). The coincidence of the spectrum obtained with serotypes members of the PCV7 pneumococcal conjugate vaccines and PKV10, was 81% in PKV13 - 90%. The proportion of strains sensitive to clindamycin, 31%, to macrolides - 40% to trimethoprim / sulfamethoxazole - 60%. Multiple resistance was observed in 37% of the identified pneumococcal serotypes. In erythromycin-resistant strains resistance was caused by the presence of ermB-gene (in 74% of cases) or mef-dependent efflux pump as the sole determinant (9%), in 17% of cases – with its association. Maximum antibiotic resistance is observed in pneumococcal vaccine serotypes. Conclusions: The results of the study comparing with previously obtained data shows stability over the past decades the spectrum of pneumococci circulating in the Russian population of children. A substantial increase in pneumococcal resistance to (especially vaccine serotypes) antibiotic penicillin, macrolides, clindamycin is observed.


About the Authors

M. A. Lazareva
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


T. V. Kulichenko
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


N. M. Alyab'eva
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


O. A. Ponamarenko
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


A. V. Lazareva
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


L. K. Katosova
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


N. A. Mayanskii
Scientific Center of Children's Health, Moscow, Russian Federation
Russian Federation


References

1. Bogaert D., van Belkum A., Sluijter M. et al. Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children. Lancet. 2004; 363: 1871–1872.

2. Harrison L.M., Morris J.A., Telford D.R. et al. The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position. FEMS Immunol. Med. Microbiol. 1999; 25: 19–28.

3. Hernandez-Bou S., Garcia-Garcia J.J., Gene A. et al. Pneumococcal carriage in children attending a hospital outpatient clinic in the era of pneumococcal conjugate vaccines in Barcelona. Diagn. Microbiol. Infect. Dis. 2012; 74: 258–262.

4. Dunai B., Bruno P., Carsenti-Dellamonica H. et al. Trends in nasopharyngeal carriage of Streptococcus pneumonia among children attending daycare centers in southern France from 1999 to 2006. Pediatr. Infect. Dis. J. 2008; 11 (27): 1033–1035.

5. Harboe Z.B., Slotved H-C., Konradsen H.B., Kaltoft M.S. A Pneumococcal Carriage Study in Danish Pre-school Children before the Introduction of Pneumococcal Conjugate Vaccination. Open Microbiol. J. 2012; 6: 40–44.

6. Sekhar S., Chakraborti A., Kumar R. Haemophilusinfluenzae colonization and its risk factors in children aged <2 years in northern India. Epidemiol. Infect. 2009; 137: 156–160.

7. De Lencastre H., Kristinsson K.G., Brito-Ava A. et al. Carriage of respiratory tract pathogens and molecular epidemiology of Streptococcus pneumoniae colonization in healthy children attending day care centers in Lisbon, Portugal. Microb. Drug Resist. 1999; 5: 19–29.

8. Masuda K., Masuda R., Nishi J. et al. Incidences of nasopharyngeal colonization of respiratory bacterial pathogens in Japanese children attending daycare centers. Pediatr. Int. 2002; 44: 376–380.

9. Principi N., Marchisio P., Schito G.C., Mannelli S., Mannelli S. Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. Pediatr. Infect. Dis. J. 1999; 18: 517–523.

10. Bogaert D., de Groot R., Hermans P.W. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. Lancet Infect. Dis. 2004; 4: 144–154.

11. Verhagen L.M., Luesink M., WarrisА. et al. Bacterial Respiratory Pathogens in Children With Inherited Immune and Airway Disorders: Nasopharyngeal Carriage and Disease Risk. Pediatr. Infect. Dis. J. 2013; 32: 399–404.

12. Walker C.L., Rudan I., Liu L., Nair H., Theodoratou E., Bhutta Z.A., O'Brien K.L., Campbell H., Black R.E. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013; 381: 1405–1416. Doi: 10.1016/S0140-6736(13)60222-6.

13. World Health Organization. Pneumococcal conjugate vaccine for childhood immunization — WHO position paper. Wееkly Epidemiol. Rec. 2007; 82: 93–104.

14. Centers for Disease Control and Prevention. Active Bacterial CoreSurveillance Report. Emerging Infections Program Network, Streptococcus pneumoniae. 2008.

15. Kandasamy R., Gurung M, Thapa A. et al. Multi-Serotype Pneumococcal Nasopharyngeal Carriage Prevalence in Vaccine Naïve Nepalese Children, Assessed Using Molecular Serotyping. PLoS One. 2015; 10 (2): 0114286.

16. Simell B., Auranen K., Käyhty H. et al. The fundamental link between pneumococcal carriage and disease. Exp. Rev. Vaccines. 2012; 11: 841–855.

17. Vu H.T., Yoshida L.M., Suzuki M. et al. Association between nasopharyngeal load of Streptococcus pneumoniae, viral coinfection, and radiologically confirmed pneumonia in Vietnamese children. Pediatr. Infect. Dis. J. 2011; 30: 11–18.

18. Syrjlnen R.K., Auranen K.J., Leino T.M. et al. Pneumococcal acute otitis media in relation to pneumococcal nasopharyngeal carriage. Pediatr. Infect. Dis. J. 2005; 24: 801–806.

19. Whitney C.G., Farley M.M., Hadler J., Harrison L.H., Bennett N.M., Lynfield R. et al. Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugates vaccine. N. Engl. J. Med. 2003; 348: 1737–1746.

20. Tocheva A.S., Jefferies J.M., Rubery H. et al. Declining serotype coverage of new pneumococcal conjugate vaccines relating to the carriage of Streptococcus pneumoniae in young children. Vaccine. 2011; 29: 4400–4404.

21. Rodenburg G.D., de Greeff S.C., Jansen A.G. et al. Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands. Emerging Infect. Dis. 2010; 16: 816–823.

22. Sa-Leao R., Nunes S., Brito-Avo A., Frazao N., Simoes A.S., Crisostomo M.I. et al. Changes in pneumococcal serotypes and antibiotypes carried by vaccinated and unvaccinated day-care centre attendees in Portugal, a country with widespread use of the sevenvalent pneumococcal conjugate vaccine. Clin. Microbiol. Infect. 2009; 15: 1002–1007.

23. Farrell D.J., Klugman K.P., Pichichero M. Increased antimicrobial resistance among nonvaccine serotypes of Streptococcus pneumoniae in the pediatric population after the introduction of the 7-valent pneumococcal vaccine in the United States. Pediatr. Infect. Dis. J. 2007; 26: 123–128.

24. Hoban D., Baquero F., Reed V., Felmingham D. Demographic analysis of antimicrobial resistance among Streptococcus pneumoniae: worldwide results from PROTECT 1999–2000. Int. J. Infect. Dis. 2005; 9: 262–273.

25. Mayanskii N.A., Alyab'eva N.M., Ivanenko A.M., Ponomarenko O.A., Katosova L.K., Lazareva A.V., Kulichenko T.V., Namazova-Baranova L.S. Bacterial etiology of acute otitis media in children up to 5 years: Streptococcus pneumoniae role. Voprosi diagnostiki v pediatrii = Diagnostics in pediatrics. 2013; 5 (3): 5–13.

26. Mayanskiy N., Alyabieva N., Ponomarenko O., Pakhomov A., Kulichenko T., Ivanenko A., Lazareva M., Lazareva A., Katosova L., Namazova-Baranova L., Baranov A. Bacterial etiology of acute otitis media and characterization of pneumococcal serotypes and genotypes among children in Moscow, Russia. Pediatr. Infect. Dis. J. 2015; 34: 255–260.

27. Metodicheskie ukazaniya. (MUK) 4.2. 1890–04 [Guidelines. (MUK) 4.2. 1890-04]. Moscow, Federal'nyi tsentr gossanepidnadzora Minzdrava Rossii, 2004. 91 p.

28. Leclercq R., Canto´n R., Brown D.F.J, Giske C.G., Heisig P., MacGowan A.P. et al. EUCAST expert rules in antimicrobial susceptibility testing. Clin. Microbiol. Infect. 2013; 19: 141–160.

29. Reinert R.R., Filimonova O.Y., Al-Lahham A., Grudinina S.A., Ilina E.N., Weigel L.M., Sidorenko S.V. Mechanisms of macrolide resistance among Streptococcus pneumoniae isolates from Russia. Antimicrob. Agents Chemother. 2008; 52: 2260–2262.

30. Baranov A.A., Namazova-Baranova L.S.. Mayanskii N.A., Kulichenko T.V. et al. The role of Streptococcus pneumoniae in the structure of bacterial infections in children hospitalized in hospitals of Moscow in 2011-2012. Pediatricheskaya farmakologiya = Pediatric pharmacology. 2013; 10 (5): 6–12.

31. Shaikh N., Leonard E., Martin J.M. Prevalence of Streptococcal pharyngitis and Streptococcal carriage in children: А meta-analysis. Pediatrics. 2010; 126 (3): 557−564.

32. Mayanskiy N., Alyabieva N., Ponomarenko O. et al. Serotypes and antibiotic resistance of non-invasive Streptococcus pneumoniae circulating in pediatric hospitals in Moscow, Russia. Int. J. Infect. Dis. 2014; 20: 58–62.

33. Kozlov R.S., Chagaryan A.N., Kozlova L.V., Murav'ev A.A. Ants Serological characteristics and antibiotic sensitivity of pneumococci isolated from children under the age of 5 years in some regions of the Russian Federation. Klinicheskaya mikrobiologicheskaya i antimikrobnaya khimioterapiya = Clinical microbiology and antimicrobial chemotherapy. 2011; 2: 177–187.

34. Katosova L.K., Sidorina T.M., Baturo A.P., Sotnikova G.D. Serotypes of S. pneumoniae in children with chronic inflammatory diseases of the respiratory system. Zhurnal mikrobiologii, epidemiologii i immunobiologii = Journal of epidemiology and microbiology, immunobiology. 1990; 2: 32-37.

35. Mayanskii N.A., Alyab'eva N.M, Katosova L.K., Grechukha T.A., Pinelis V.G., Namazova-Baranova L.S. Definition of capsular serotypes of pneumococcus by multiplex PCR. Voprosi diagnostiki v pediatrii = Diagnostics in pediatrics. 2010; 2, (6): 6-10.

36. Kharit S.M., Sidorenko S.V., Ruleva A.A. et al. The prevalence of pneumococcal pneumonia and ear infections in young children (preliminary data). Voprosy sovremennoi pediatrii = Current pediatrics. 2011; 10 (6): 103–107.

37. Richter S.S., Heilmann K.P., Dohrn C.L., Riahi F., Diekema D.J., Doern G.V. Pneumococcal Serotypes before and after Introduction of Conjugate Vaccines, United States, 1999–2011. Emerg. Infect. Dis. 2013; 19: 1074–1083.

38. Weinberger D.M., Malley R., Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet. 2011; 378: 1962–1973.

39. Stratchounski L.S., Kretchikova O.I., Kozlov R.S., Reshedko G.K., Stetsiouk O.U., Tarasova G.D., Blochin B.M., Egorova O.A., Boyko L.M. Antimicrobial resistance of Streptococcus pneumoniae isolated from healthy children in day-care centers: results of a multicenter study in Russia. Pediatr. Infect. Dis. J. 2000; 19: 196–200.

40. Stratchounski L.S., Kozlov R.S., Appelbaum P.C., Kretchikova O.I., Kosowska-Shick K. Antimicrobial resistance of nasopharyngeal pneumococci from children from day-care centres and orphanages in Russia: results of a unique prospective multicentre study. Clin. Microbiol. Infect. 2006; 12: 853–866.

41. Song J.H., Dagan R., Klugman K., Fritzel B. The relationship between pneumococcal serotypes and antibiotic resistance. Vaccine. 2012; 30: 2728–2737.

42. Dagan R. Impact of pneumococcal conjugate vaccine on infections caused by antibiotic-resistant Streptococcus pneumoniae. Clin. Microbiol. Infect. 2009; 15 (Suppl. 3): 16–20.

43. Reinert R.R. The antimicrobial resistance profile of Streptococcus pneumonia. Clin. Microbiol. Infect. 2009; 15 (Suppl. 3): 7–11.

44. Kozlov R.S., Sivaya O.V., Krechikova O.I., Ivanchik N.V. Dynamics of Streptococcus pneumoniae resistance to antibiotics in Russia in the period of 1999-2009. Klinicheskaya mikrobiologicheskaya i antimikrobnaya khimioterapiya = Clinical microbiology and antimicrobial chemotherapy. 2010; 12 (4): 329–341.

45. Reinert R.R., Filimonova O.Y., Al-Lahham A., Grudinina S.A., Ilina E.N., Weigel L.M., SidorenkoS.V. Mechanisms of macrolide resistance among Streptococcus pneumoniae isolates from Russia. Antimicrob. Agents Chemother. 2008; 52: 2260–2262.

46. Linares J., Ardanuy C., Pallares R., Fenoll A. Changes in antimicrobial resistance, serotypes and genotypes in Streptococcus pneumoniae over a 30-year period. Clin. Microbiol. Infect. 2010; 16: 402–410.


Review

For citations:


Lazareva M.A., Kulichenko T.V., Alyab'eva N.M., Ponamarenko O.A., Lazareva A.V., Katosova L.K., Mayanskii N.A. NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN ORPHANS, PRESCHOOL CHILDREN AND UNORGANIZED CHILDREN UNDER 5 YEARS. Current Pediatrics. 2015;14(2):246-255. (In Russ.) https://doi.org/10.15690/vsp.v14i2.1293

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