Shahid Shahira, Nisar Muhammad Imran, Jehan Fyezah, Ahmed Sheraz, Kabir Furqan, Hotwani Aneeta, Muneer Sahrish, Qazi Muhammad Farrukh, Muhammad Sajid, Ali Asad, Zaidi Anita K M, Iqbal Najeeha T
Department of Pediatric and Child Health, Aga Khan University, Karachi, Pakistan.
Bill & Melinda Gates Foundation, Seattle, WA, USA.
Clin Epidemiol Glob Health. 2023 May-Jun;21:None. doi: 10.1016/j.cegh.2023.101293.
and are common colonizers of the human nasopharynx. In this study, we describe nasopharyngeal carriage and evaluate its association with carriage post-10-valent pneumococcal conjugate vaccine (PCV10) introduction in Pakistan.
A serial cross-sectional study was undertaken from 2014 to 2018, children <2 years were randomly selected, and nasopharyngeal swabs were collected using standard WHO guidelines. and isolates were identified using standard methods and tested for antimicrobial susceptibility by the standard Kirby-Bauer disk-diffusion method as per Clinical & Laboratory Standards Institute (CLSI) recommendations. Regression analysis was used to determine predictors associated with carriage.
We enrolled 3140 children. carriage prevalence was 5.6% (176/3140), and 50.1% (81/176) of the isolates were methicillin-resistant (MRSA). carriage was higher in the absence of pneumococcus compared to isolates in which pneumococcus was present (7.5% vs 5.0%). carriage was negatively associated with pneumococcal carriage, being in 3rd and 4th year of enrollment, and vaccination with two and three PCV10 doses, in addition, fast breathing, ≥2 outpatients visits, and rainy season were positively associated. The following resistance rates were observed: 98.9% for penicillin, 74.4% for fusidic acid, and 23.3% for gentamicin, 10.2% for erythromycin, and 8.5% for cotrimoxazole. All isolates were susceptible to amikacin.
Overall carriage prevalence was low, PCV10 vaccine was protective against the carriage. The proportion of MRSA carriage and antimicrobial resistance was high in this community warranting continuous monitoring for invasive infections.
[具体细菌名称1]和[具体细菌名称2]是人类鼻咽部常见的定植菌。在本研究中，我们描述了[具体细菌名称1]的鼻咽部定植情况，并评估其与巴基斯坦引入10价肺炎球菌结合疫苗（PCV10）后[具体细菌名称2]定植的相关性。
2014年至2018年进行了一项系列横断面研究，随机选取2岁以下儿童，按照世界卫生组织标准指南采集鼻咽拭子。使用标准方法鉴定[具体细菌名称1]和[具体细菌名称2]分离株，并根据临床和实验室标准协会（CLSI）的建议，采用标准的 Kirby-Bauer 纸片扩散法检测抗菌药物敏感性。采用回归分析确定与[具体细菌名称1]定植相关的预测因素。
我们纳入了3140名儿童。[具体细菌名称1]的定植率为5.6%（176/3140），其中50.1%（81/176）的分离株为耐甲氧西林[具体细菌名称1]（MRSA）。与存在肺炎球菌的分离株相比，不存在肺炎球菌时[具体细菌名称1]的定植率更高（7.5%对5.0%）。[具体细菌名称1]定植与肺炎球菌定植呈负相关，与入组的第3年和第4年、接种2剂和3剂PCV10疫苗呈负相关，此外，呼吸急促、门诊就诊≥2次和雨季与之呈正相关。观察到以下耐药率：青霉素为98.9%，夫西地酸为74.4%，庆大霉素为23.3%，红霉素为10.2%，复方新诺明为8.5%。所有分离株对阿米卡星敏感。
总体而言，[具体细菌名称1]的定植率较低，PCV10疫苗对其定植有保护作用。该社区中MRSA定植比例和抗菌药物耐药性较高，需要持续监测侵袭性感染情况。
