title: Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae strains carried by children infected with human immunodeficiency virus.
abstract: BACKGROUND
  We studied the serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae isolates carried by children infected with HIV in Jakarta, Indonesia.
  
  
  METHODS
  Nasopharyngeal swabs were collected from 90 HIV infected children aged 4 to 144 months. S. pneumoniae was identified by conventional and molecular methods. Serotyping was performed with sequential multiplex PCR and antibiotic susceptibility with the disk diffusion method.
  
  
  RESULTS
  We identified S. pneumoniae carriage in 41 children (46%). Serotype 19 F was most common among 42 cultured strains (19%) followed by 19 A and 6A/B (10% each), and 23 F (7%). Most isolates were susceptible to chloramphenicol (86%), followed by clindamycin (79%), erythromycin (76%), tetracycline (43%), and sulphamethoxazole/trimethoprim (41%). Resistance to penicillin was most common with only 33% of strains being susceptible. Strains of serotypes targeted by the 13-valent pneumococcal conjugate polysaccharide vaccine (PCV13) were more likely to be multidrug resistant (13 of 25 or 52%) compared to non-PCV13 serotype isolates (3 of 17 or 18%; Fisher exact test p = 0.05).
  
  
  CONCLUSIONS
  Our study provides insight into the epidemiology of pneumococcal carriage in young HIV patients in Indonesia. These findings may facilitate potential preventive strategies that target invasive pneumococcal disease in Indonesia.
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: Dodi
authors.initials: D
authors.lastname: Safari
authors.affiliation: Department of Child Health, Dr. Cipto Mangunkusumo Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Nia
authors.initials: N
authors.lastname: Kurniati
authors.affiliation: Eijkman Oxford Clinical Research Unit, Jakarta, Indonesia.
authors.forename: Lia
authors.initials: L
authors.lastname: Waslia
authors.affiliation: Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
authors.forename: Miftahuddin Majid
authors.initials: MM
authors.lastname: Khoeri
authors.affiliation: Faculty of Biology, Gajah Mada University, Yogyakarta, Indonesia.
authors.forename: Tiara
authors.initials: T
authors.lastname: Putri
authors.affiliation: Department of Pediatric Immunology and Infectious Diseases, Wilhelmina?s Children Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Debby
authors.initials: D
authors.lastname: Bogaert
authors.affiliation: Department of Pediatric Immunology and Infectious Diseases, Wilhelmina?s Children Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Trzciński
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D007214:Indonesia; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents