Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana.
Dept. of Microbiology, Korle Bu Teaching Hospital, Accra, Ghana.
Biomed Res Int. 2019 Feb 13;2019:3427174. doi: 10.1155/2019/3427174. eCollection 2019.
Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism. This was a cross sectional study involving 245 HIV/AIDS patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from November 2016 to March 2017. Epidemiological data on demographic, household and clinical features of the study participants were collected. Nasopharyngeal (NP) swabs were also collected from the study participants and cultured for ; the isolates were serotyped by latex agglutination and Quellung reaction. Antimicrobial disc susceptibility was performed on the isolates, and antibiotics tested included tetracycline, erythromycin, cotrimoxazole, levofloxacin, oxacillin and ceftriaxone. Prevalence of pneumococcal carriage among the study participants was 11% (95% CI: 7.4 to 15.6); carriage among children and adults was 25% (95% CI: 14% to 38.9%) and 7.3% (95% CI: 4% to 11.9%) respectively. School attendance (p=0.001) and history of pneumococcal disease in the past year (p=0.001) were significantly associated with pneumococcal carriage. The most prevalent pneumococcal serotypes carried by the study participants were 19A (15.4%) and 23F (15.4%). Serotype coverage of the various pneumococcal vaccines were PCV10 (23.1%), PCV13 (42.3%) and PPV23 (50%). The prevalence of pneumococcal multidrug resistance was 18.5%. In conclusion, pneumococcal carriage among HIV-infected children was three-fold higher compared to carriage among HIV-infected adults. Pneumococcal carriage among both HIV-infected children and adults in the study area tends to be characterized by a predominance of non-vaccine serotypes and a considerable level of multidrug resistance.
携带肺炎球菌被认为是肺炎球菌病发展的前兆。在撒哈拉以南非洲地区，在肺炎球菌结合疫苗时代，针对艾滋病毒感染者的肺炎球菌研究很少。本研究调查了加纳南部艾滋病毒/艾滋病患者的肺炎球菌携带情况，以确定该病原体的流行率、危险因素、血清型和抗生素耐药性。这是一项横断面研究，涉及 2016 年 11 月至 2017 年 3 月从科勒布教学医院和阿克拉的玛丽·路易斯公主医院招募的 245 名艾滋病毒/艾滋病患者。收集了研究参与者的人口统计学、家庭和临床特征的流行病学数据。还从研究参与者中采集鼻咽（NP）拭子并进行培养；分离株通过乳胶凝集和 Quellung 反应进行血清分型。对分离株进行了抗生素药敏试验，测试的抗生素包括四环素、红霉素、复方新诺明、左氧氟沙星、苯唑西林和头孢曲松。研究参与者的肺炎球菌携带率为 11%（95%CI：7.4%至 15.6%）；儿童和成人的携带率分别为 25%（95%CI：14%至 38.9%）和 7.3%（95%CI：4%至 11.9%）。上学（p=0.001）和过去一年中肺炎球菌病史（p=0.001）与肺炎球菌携带显著相关。研究参与者携带的最常见肺炎球菌血清型为 19A（15.4%）和 23F（15.4%）。各种肺炎球菌疫苗的血清型覆盖率为 PCV10（23.1%）、PCV13（42.3%）和 PPV23（50%）。肺炎球菌多药耐药率为 18.5%。总之，与感染艾滋病毒的成年人相比，感染艾滋病毒的儿童的肺炎球菌携带率高出三倍。研究地区感染艾滋病毒的儿童和成年人的肺炎球菌携带情况往往以非疫苗血清型为主，并且具有相当水平的多药耐药性。
