title: Antibiotic resistance of Streptococcus pneumoniae colonising the nasopharynx of HIV-exposed Tanzanian infants.
abstract: OBJECTIVE
  To determine antibiotic susceptibility of colonising pneumococcal serotypes in HIV-exposed infants before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), because HIV-exposed infants are at increased risk of invasive pneumococcal infections.
  
  
  METHODS
  Antibiotic susceptibility of 104 pneumococcal isolates, cultured from the nasopharynx from Tanzanian HIV-exposed infants, was determined using the disc diffusion method and the E-test according to EUCAST version 4.0 (2014) criteria.
  
  
  RESULTS
  A total of 69.2% of isolates were intermediately susceptible for benzyl penicillin (MIC 0.06-2 mg/l ); no high-level resistance was found. All isolates but one were susceptible to ampicillin. Regarding non-beta-lactam antibiotics, 19.2% of isolates were resistant to doxycycline, 3.8% to erythromycin and 97.1% to trimethoprim/sulfamethoxazole. A total of 15.4% of isolates were resistant to three antibiotic classes or more. There were no differences in antibiotic susceptibility between vaccine and non-vaccine serotypes. Reduced susceptibility of colonising pneumococcal isolates for commonly used antibiotics is common in HIV-exposed Tanzanian infants.
  
  
  CONCLUSIONS
  High-dose penicillin and ampicillin remain appropriate first choices for non-meningeal pneumococcal infections in this group.
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Bles
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Q
authors.initials: Q
authors.lastname: de Mast
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.|Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
authors.forename: C E
authors.initials: CE
authors.lastname: van der Gaast-de Jongh
authors.affiliation: Department of Pediatrics, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: G D
authors.initials: GD
authors.lastname: Kinabo
authors.affiliation: Kilimanjaro Christian Medical University College, Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
authors.forename: G
authors.initials: G
authors.lastname: Kibiki
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van de Ven
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.|Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
authors.forename: M I
authors.initials: MI
authors.lastname: de Jonge
keywords: 
  Streptococcus pneumoniae
  ; HIV-exposed infants; Streptococcus pneumoniae; Tanzania; Tanzanie; antibiotic resistance; colonisation; colonización; niños expuestos al VIH; nourrissons exposés au VIH; resistencia antibiótica; résistance aux antibiotiques