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埃塞俄比亚西南部五岁以下儿童肺炎链球菌的鼻咽部携带情况及药敏模式

Nasopharyngeal Carriage and Antimicrobial Susceptibility Patterns of Streptococcus pneumoniae among Children under Five in Southwest Ethiopia.

作者信息

Gebre Tiglu, Tadesse Mulualem, Aragaw Dossegnaw, Feye Dagne, Beyene Habtamu Bedimo, Seyoum Dinberu, Mekonnen Mekidim

机构信息

Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia.

Mycobacteriology Research Center, Institute of Biotechnology, Jimma University, P.O. Box 378, Jimma, Ethiopia.

出版信息

Children (Basel). 2017 Apr 19;4(4):27. doi: 10.3390/children4040027.

Abstract

Nasopharyngeal carriage of is found to play an important role in the development and transmission of pneumococcal diseases. In this study, we assessed the nasopharyngeal carriage, antimicrobial susceptibility patterns and associated risk factors of among children under five. A total of 361 children under five attending the outpatient department of Shanan Gibe Hospital in Jimma, Southwest Ethiopia were enrolled from June to September 2014. Nasopharyngeal specimens were collected using sterile plastic applicator rayon tipped swab and inoculated on tryptone soy agar supplemented with 5% sheep blood and 5 µg/mL gentamycin. Antimicrobial susceptibility testing was performed using the modified disk diffusion method. The overall prevalence of carriage was 43.8% (158/361) among children under five. Resistance to tetracycline, cotrimoxazole, penicillin, chloramphenicol and erythromycin was observed in 53.2% (84/158), 43.7% (69/158), 36.1% (57/158), 13.3% (21/158) and 8.9% (14/158) of isolates respectively. Multidrug resistance was seen in 17.7% (28/158) of isolates. In multivariate logistic regression analysis, children living with sibling(s) < 5 years old (adjusted odds ratio (AOR) = 1.798; 95% confidence interval (CI), 1.169-2.766) and malnutrition (AOR = 2.065; 95% CI, 1.239-3.443) were significantly associated with carriage. A high nasopharyngeal carriage of was observed among children under five in Southwest Ethiopia. There should be a strategy to prevent nasopharyngeal colonization and identify the appropriate antibiotic to the individual child.

摘要

肺炎链球菌的鼻咽部携带被发现对肺炎球菌疾病的发生和传播起着重要作用。在本研究中,我们评估了五岁以下儿童肺炎链球菌的鼻咽部携带情况、抗菌药物敏感性模式及相关危险因素。2014年6月至9月,从埃塞俄比亚西南部吉马的沙南吉贝医院门诊部招募了361名五岁以下儿童。使用无菌塑料涂抹器的含人造纤维头拭子采集鼻咽部标本,并接种于添加5%羊血和5μg/mL庆大霉素的胰蛋白胨大豆琼脂上。采用改良纸片扩散法进行抗菌药物敏感性试验。五岁以下儿童肺炎链球菌携带的总体患病率为43.8%(158/361)。分别在53.2%(84/158)、43.7%(69/158)、36.1%(57/158)、13.3%(21/158)和8.9%(14/158)的分离株中观察到对四环素、复方新诺明、青霉素、氯霉素和红霉素的耐药性。17.7%(28/158)的分离株存在多重耐药性。在多因素logistic回归分析中,与五岁以下兄弟姐妹一起生活的儿童(调整优势比(AOR)=1.798;95%置信区间(CI),1.169 - 2.766)和营养不良(AOR = 2.065;95%CI,1.239 - 3.443)与肺炎链球菌携带显著相关。在埃塞俄比亚西南部五岁以下儿童中观察到肺炎链球菌的高鼻咽部携带率。应制定策略以预防肺炎链球菌的鼻咽部定植,并为每个儿童确定合适的抗生素。

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