Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Venezuelan children

Abstract number: P2205

Rivera-Olivero I., del Nogal B., Sisco M.C., Bogaert D., Hermans P.H.M., de Waard J.H.

Objective: To determine the prevalence of, risk factors and serotype-distribution of pneumococcal carriage in healthy Venezuelan children in Caracas, with emphasis on the theoretical coverage of the 7-valent pneumococcal conjugate vaccine.

Methods: Nasopharyngeal swabs were taken from 557 healthy children aged 3–36 months attending the Healthy Children Service at Hospital de Niños "J.M. de Los Rios" in Caracas between December 2006 and August 2007. The swabs were cultured for Streptococcus pneumoniae, the isolates were serotyped and their susceptibility for penicillin, erythromycin, clindamycin, tetracycline, levofloxacin, vancomycin, trimethoprim/sulfamethaxazole and linezolid assessed by disk diffusion. Risk factors such as care centre attendance, young age, recent antibiotic use, race, current otitis media and social level were analysed by univariate and multivariate logistic regression analysis.

Results: In total, 111 pneumococcal isolates were collected. The overall carriage rate for S. pneumoniae was 20%, not significantly varying with age or time of year the sample was taken. The most important capsular serotypes/serogroups were 6 A and B (42%), 14 (11.3%), 23F (8%), 19A (6.5%) and 19F (5%). The theoretical coverage of the 7-valent pneumococcal conjugate vaccine was 74% (including cross-reactive serotypes). 45% of the pneumococcal isolates were resistant to one or more antibiotics. The rate of penicillin and macrolide resistance were 30% and 28%, respectively. Multi-drug resistance was found in 25% of the strains. No risk factors for pneumococcal carriage were identified.

Conclusions: The prevalence of pneumococcal colonisation in these children was low (20%) and didn't vary with age. A possible reason for the low carriage rate might be the fact that this epidemiological survey addressed only healthy children. The serotypes most frequently found in our healthy population (6 A/B, 14, 23F, 19A and 19F) are those commonly involved in invasive pneumococcal diseases in Venezuela, highlighting the importance of nasopharyngeal carriage in the development of severe infections. The theoretical coverage of the 7-valent pneumococcal conjugate vaccine was high. None of the risk factors described in previous studies were found to be related to pneumococcal colonisation in this population. However, this is an ongoing study and the small number of carriers found up to now is limiting the statistical power of univariate and multivariate analysis.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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