Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Clin Microbiol Infect. 2013 Mar;19(3):235-41. doi: 10.1111/j.1469-0691.2012.03771.x. Epub 2012 Feb 13.
Sickle cell anaemia (SCA) is a haemoglobin disorder that alters the deformability of erythrocytes through abnormal polymerization of haemoglobin. Children with SCA have an increased risk of infections with encapsulated bacteria. To guide the antibiotic prophylaxis and vaccinations in children with SCA in Gabon, we characterized Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae from children with and without SCA. We performed a cross-sectional study and compared nasal and pharyngeal S. pneumoniae, Staph. aureus and H. influenzae isolates from SCA children (n = 73) with comparators matched for age, residence and sex (n = 143) in a matched-comparison analysis. The resistance pattern and capsular type were identified for each isolate. The total carriage rate for S. pneumoniae, Staph. aureus and H. influenzae was 13.8%, 46.7% and 12.5%, respectively, and did not differ between groups (p >0.05). The mean number of days under antibiotic treatment in the past year was higher in children with SCA than in controls (penicillin: 70.1 vs 0.1 days, p 0.00002). The total non-susceptibility rate was 30% for oral and parenteral (meningitis) penicillin in S. pneumoniae, resistance rates were 1.6% for oxacillin in Staph. aureus and 14.8% for ampicillin in H. influenzae. Susceptibility to antibiotic agents and distribution of capsular types did not differ significantly between both groups. In conclusion, carriage and resistance rates are similar in children with and without SCA. Our data provide the basis to guide empiric therapy of invasive diseases caused by S. pneumoniae, Staph. aureus and H. influenza in children in Gabon.
镰状细胞贫血症（SCA）是一种血红蛋白疾病，通过血红蛋白的异常聚合改变红细胞的变形能力。患有 SCA 的儿童感染带荚膜细菌的风险增加。为了指导加蓬 SCA 儿童的抗生素预防和疫苗接种，我们对 SCA 儿童（n=73）和无 SCA 儿童（n=143）的鼻咽部肺炎链球菌、金黄色葡萄球菌和流感嗜血杆菌进行了特征分析。我们进行了一项横断面研究，并在匹配比较分析中比较了 SCA 儿童（n=73）和年龄、居住地和性别匹配的对照组（n=143）的鼻咽部肺炎链球菌、金黄色葡萄球菌和流感嗜血杆菌分离株。鉴定了每个分离株的耐药模式和荚膜型。肺炎链球菌、金黄色葡萄球菌和流感嗜血杆菌的总携带率分别为 13.8%、46.7%和 12.5%，两组之间无差异（p>0.05）。SCA 儿童过去一年抗生素治疗天数中位数高于对照组（青霉素：70.1 天 vs 0.1 天，p<0.00002）。肺炎链球菌口服和（脑膜炎）注射用青霉素的总不敏感率为 30%，金黄色葡萄球菌对苯唑西林的耐药率为 1.6%，流感嗜血杆菌对氨苄西林的耐药率为 14.8%。两组之间抗生素药物的敏感性和荚膜型分布无显著差异。结论：SCA 儿童与无 SCA 儿童的携带率和耐药率相似。我们的数据为指导加蓬儿童侵袭性疾病的经验性治疗提供了依据，这些疾病由肺炎链球菌、金黄色葡萄球菌和流感嗜血杆菌引起。
