TITLE:
Penicillin Resistance in Nasopharyngeal Streptococcus pneumoniae among Children with Sickle Cell Disease Immunized with 7-Valent Pneumococcal Conjugate Vaccine
AUTHORS:
Patricia Belintani Blum Fonseca, Calil Kairalla Farhat, Regina Célia de Menezes Succi, Antônia Maria de Oliveira Machado, Josefina Aparecida Pellegrini Braga
KEYWORDS:
Sickle Cell Disease; Nasopharyngeal Carriage; Streptococcus pneumoniae; Antimicrobial Resistance; Vaccine
JOURNAL NAME:
World Journal of Vaccines,
Vol.3 No.2,
May
22,
2013
ABSTRACT: To assess the prevalence,
the antimicrobials resistance and to identify risk factors of nasopharyngeal
colonization by Streptococcus pneumoniae in
children with sickle cell disease (SCD) using prophylactic penicillin and
immunized with 7-valent pneumococcal conjugate vaccine. A total of 424 swabs
were collected from the nasopharynx in 216 children with SCD and 109 samples
from the control group, both from 2 to 60 months age range. Isolation and
identification of pneumococci followed standard procedures. Minimum inhibitory
concentration (MIC) for penicillin was determined by the E-test method.
Prevalence of nasopharyngeal colonization by pneumococci in children with SCD
was 17%, and 11% in the control group. The risk factors for increased
colonization in children with SCD were the presence of more than five people at
home, daycare/school attendance and low prophylaxis compliance. The prevalence
of strains with penicillin resistance was 57.5% in patients with SCD and 25% in
the control group. Conclusions: Prevalence
of pneumococci nasopharyngeal colonization was similar among the study groups.
Prophylactic use of penicillin may have increased the prevalence of resistant
strains. The vaccine did not decrease the colonization with penicillin
resistant strains.