Nasopharyngeal carriage of Streptococcus pneumonia in pneumonia-prone age groups in Semarang, Java Island, Indonesia.
BACKGROUND
Streptococcus pneumoniae is a worldwide occurring pathogen Nasopharyngeal carriage of Streptococcus pneumoniae precedes pneumonia and other pneumococcal diseases in the community. Little is known about S. pneumoniae carriage in Indonesia, complicating strategies to control pneumococcal diseases. We investigated nasopharyngeal carriage of S. pneumoniae in Semarang, Indonesia.


METHODS
A population-based survey was performed in Semarang, Indonesia. Nasopharyngeal swabs and questionnaires were taken from 496 healthy young (6-60 month-old) children and 45-70 year-old adults.


RESULTS
Forty-three percent of children aged 6-60 months and 11% of adults aged 45-75 years carried S. pneumoniae. Determinants of carriage were being a child (OR 7.7; 95% CI = 4.5-13.0), passive smoking (OR 2.1; 95% CI = 1.3-3.4), and contact with toddler(s) at home (OR 3.0; 95% CI = 1.9-4.7). The most frequent serotypes found were 6A/B and 15B/C. The current commercially available vaccines cover <50% serotypes found in children. Twenty-four percent of S. pneumoniae strains were penicillin non-susceptible, and 45% were resistant to cotrimoxazol.


CONCLUSIONS
The limited coverage of commercially available vaccines against the serotypes found in this population, and the high proportion of non-susceptibility to penicillin and cotrimoxazol suggest the need for region-specific information and strategies to control S. pneumoniae.
Department of Microbiology, Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital, Semarang, Indonesia.
Helmia
H
Farida
Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Juliëtte A
JA
Severin
Department of Internal Medicine, Dr. Kariadi Hospital - Faculty of Medicine Diponegoro University, Semarang, Indonesia.
M Hussein
MH
Gasem
Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Monique
M
Keuter
Department of Microbiology, Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital, Semarang, Indonesia.
Hendro
H
Wahyono
Department of Infectious Diseases, Leiden University Medical Centre, Leiden, the Netherlands.
Peterhans
P
van den Broek
Nijmegen Institute for Infection, Inflammation, and Immunity (N4i), Nijmegen, the Netherlands ; Laboratory of Paediatric Infectious Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands ; Crucell - Johnson and Johnson, Leiden, the Netherlands.
Peter W M
PW
Hermans
Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Henri A
HA
Verbrugh
D000328:Adult; D000890:Anti-Infective Agents; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007214:Indonesia; D007223:Infant; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology*; D010406:Penicillins; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D000890:Anti-Infective Agents; D010406:Penicillins; D015662:Trimethoprim, Sulfamethoxazole Drug Combination