CC BY-NC-ND 4.0 · J Pediatr Infect Dis 2021; 16(05): 205-215
DOI: 10.1055/s-0041-1731343
Original Article

Factors Associated with Streptococcus pneumoniae Nasopharyngeal Carriage and Antimicrobial Susceptibility among Children Under the Age of 5 Years in the Southwestern Colombia

1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
Juan Pablo Rojas
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
5  School of Health, Valle University, Cali, Colombia
,
Santiago Cardona
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
3  Club Noel Children's Clinical Foundation, Cali, Colombia
,
María Alejandra Palacio
1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
,
Luis Fernando Mejía
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
,
José Luis Torres
1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
,
Jaime Contreras
3  Club Noel Children's Clinical Foundation, Cali, Colombia
,
Laura Mery Muñoz
1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
,
Javier Criales
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
,
Luis Felipe Vélez
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
Angélica María Forero
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
,
Yulieth Alexandra Zúñiga
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
María Eugenia Cuastumal
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
,
Leidy Johanna Acevedo
1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
,
Álvaro de Jesús Molina
3  Club Noel Children's Clinical Foundation, Cali, Colombia
4  Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
,
Johan Alexis Bolivar
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
Alejandro Gómez-Mejia
6  Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
7  Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
,
Jessica Lorena Morales
1  Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
2  Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
,
Sven Hammerschmidt
7  Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
› Author Affiliations
Funding This work was supported by Pfizer, Inc., through the grant: IIR WI244770.

Abstract

Objective This work aimed to evaluate the factors associated with Streptococcus pneumoniae nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in southwestern Colombia, 2019.

Methods A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage.

Results A total of 452 children under the age of 5 years were examined in which 41.8% carried S. pneumoniae. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%).

Conclusion The 41.8% of participants carrying S. pneumoniae show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.

Authors' Contributions

G.G., J.P.R., L.F.M., J.C.O., L.J.A., J.A.B., A.G.M., J.L.M., and S.H. were involved in conceptualization. G.G., J.P.R., S.C., M.A.P., J.L.T., L.M.M., L.F.V., Y.A.Z., and J.L.M. were involved in data curation. G.G., J.P.R., J.L.M., and S.H. were involved in formal analysis. G.G. assisted in funding acquisition. All authors were involved in investigation and in methodology. G.G. was involved in project administration and managed resources. G.G., J.P.R., and S.H. were involved in supervision. G.G. and J.L.M. were involved in validation. G.G. and J.L.M. were involved in visualization. G.G, A.G.M., and J.L.M. were involved in writing of original draft. G.G., J.P.R., S.C., J.D.C., M.A.P., L.F.M., J.L.T., J.C.O., L.M.M., J.C.R., L.F.V., A.M.F., Y.A.Z., M.E.C., L.J.A., A.J.M., J.A.B., A.G.M., J.L.M., and S.H. were involved in writing and editing of the draft.




Publication History

Received: 31 October 2020

Accepted: 01 May 2021

Publication Date:
26 June 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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