title: Nasopharyngeal Carriage, Capsular and Molecular Serotyping and Antimicrobial Susceptibility of Streptococcus pneumoniae among Asymptomatic Healthy Children in Egypt.
abstract: Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide with increasing antimicrobial resistance. 600 randomly chosen asymptomatic healthy children aged 2-60 months attending Alexandria University Children's Hospital were evaluated for prevalence of nasopharyngeal (NP) carriage of S. pneumoniae. Prevalence of NP carriage was 29.2% (n = 175/600) Capsular serotyping was done using Quellung reaction. Vaccine covered serotypes (VST) represented 67.4% while non-vaccine serotypes (NVST) were 32.6%. The most common VST isolated were 19F (24.6%), 6B (14.3%) and 6A (10.9%). Confirmation of serotyping was performed by multiplex PCR which showed 100% concordance with the Quellung reaction. Antimicrobial susceptibility testing showed penicillin non-susceptibility of 15% (using non-meningitis penicillin MIC breakpoints) and 55% (using meningitis penicillin MIC breakpoints). Highest resistance was found in sulphamethoxazole-trimethoprim (55%), tetracyclins (49%), erythromycin (40%) and clindamycin (25%). This study revealed the epidemiological importance to evaluate regularly the prevalence, serotypes and the increasing antimicrobial resistance of S. pneumoniae in the community.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: El-Nawawy
authors.affiliation: Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt.
authors.forename: Soad F
authors.initials: SF
authors.lastname: Hafez
authors.affiliation: Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt.
authors.forename: Marwa A
authors.initials: MA
authors.lastname: Meheissen
authors.affiliation: Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt n_ali12@alexmedmed.edu.eg.
authors.forename: Nehal M
authors.initials: NM
authors.lastname: Shahtout
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt.
authors.forename: Essam E
authors.initials: EE
authors.lastname: Mohammed
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D024881:Drug Resistance, Bacterial; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D060885:Multiplex Polymerase Chain Reaction; D009305:Nasopharynx / Q000382:microbiology; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D015995:Prevalence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000890:Anti-Infective Agents; D022242:Pneumococcal Vaccines
keywords: Quellung; Streptococcus pneumoniae; antimicrobial susceptibility; multiplex PCR; nasopharyngeal carriage; serotype