title: [Study of nasopharyngeal colonization by Streptococcus pneumoniae and its antibiotics resistance in healthy children less than 2 years of age in the Marrakech region (Morocco)].
abstract: The healthy carrier of Streptococcus pneumoniae (S. pneumoniae) has been studied very little at the national level. With the emergence of antibiotic-resistant strains worldwide, and the emergence of new serotypes, an epidemiological survey is needed before the vaccine can be introduced in Morocco.
  
  
  OBJECTIVE
  This study's objective was to determine the prevalence and risk factors of pneumococcal nasopharyngeal carriage in children less than 2 years of age in the Marrakech region and to assess the antibiotic susceptibility of the isolates and the serotypes present prior to the introduction of the conjugate pneumococcal vaccine.
  
  
  METHODS
  From 2008 to 2009, 660 nasopharyngeal samples were collected on children under 2 years of age during scheduled visits to dispensaries for routine immunization in the Marrakech region.
  
  
  RESULTS
  S. pneumoniae carriage was found in 45.8% of children. Of the 660 samples, 302 strains were isolated. The percentage of pneumococcal strains with reduced susceptibility to penicillin (PRSP) was 34.7%. Among these strains, 87.1% showed low-level resistance and 12.9% high-level resistance. Resistance to amoxicillin was found in 3.3% of the strains and no strains were resistant to cefotaxime. Several risk factors for pneumococcal carriage were identified, the main ones being breastfeeding less than 2 months, the presence of more than one sibling, passive smoking, and low socioeconomic level. The most frequent serotypes were 19F, 6, 14, 23, 18, and 9. The study of the vaccine serotype distribution showed that the theoretical vaccine coverage of the 7 valent vaccines was at 57% for all the isolates.
  
  
  CONCLUSIONS
  These data show the frequency and the risk factors on nasopharyngeal carriage, and report the status of penicillin resistance of strains carrying children less than 2 years of age in the Marrakech region. The fluctuation of circulating serotypes at the national level underscores the importance of epidemiological surveillance carried out before the introduction of the heptavalent vaccine in Morocco.
authors: Laboratoire de microbiologie, faculté de médecine et de pharmacie de Marrakech, université cadi Ayyad, CHU Mohammed-VI, Marrakech, Maroc.
authors: M
authors: M
authors: Bouskraoui
authors: N
authors: N
authors: Soraa
authors: K
authors: K
authors: Zahlane
authors: L
authors: L
authors: Arsalane
authors: C
authors: C
authors: Doit
authors: P
authors: P
authors: Mariani
authors: E
authors: E
authors: Bingen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D009018:Morocco / Q000453:epidemiology; D009305:Nasopharynx / Q000382:microbiology*; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D015995:Prevalence; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D018074:Vaccines, Conjugate
chemical_list: D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate