Nasopharyngeal carriage and antibiotic susceptibility patterns of streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis and staphylococcus aureus among urban Ugandan children post-PCV10 introduction: a cross-sectional study

Afr Health Sci. 2023 Dec;23(4):216-229. doi: 10.4314/ahs.v23i4.24.

Abstract

In 2013, Uganda introduced the PCV10 pneumococcal vaccine and it is given to children at 6, 10 and 14 weeks after birth. Carriage prevalence studies post PCV10-introduction are necessary for monitoring the impact of vaccination and trends in antibiotic resistance. Here, we studied carriage/antibiotic resistance of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus isolated from 194 children at the Mulago Assessment Centre clinic in Kampala-Uganda, 5 years post-PCV10 introduction. Almost all the children were vaccinated with PCV10 (98.5%, 191/194). The overall carriage prevalence (any species) was 62% (120/194), and it was associated with a history of antibiotics use (p=0.0159) and having respiratory symptoms (p=0.0003). The pneumococcus, H. influenzae, M. catarrhalis, and S. aureus carriage prevalence was 46% (90/194), 21% (40/194), 7% (14/194), and 6% (12/194), respectively. Species co-carriage occurred in 32 children (17%, 32/194), predominantly multidrug resistant pneumococcus + H. influenzae (23 children). Furthermore, pneumococci were highly resistant to cotrimoxazole (100%), erythromycin (76%), and tetracycline (52%), 42% being multidrug-resistant. Overall, we note an increase in antibiotic resistance post-PCV10 introduction, and microbial shifts i.e., a decrease in pneumococcus, M. catarrhalis and S. aureus carriage and an increase in H. influenzae carriage suggesting vaccine-associated perturbation of the respiratory ecology.

Keywords: Antibiotic resistance; Bacterial colonization; Bacterial isolates.

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Carrier State* / epidemiology
  • Carrier State* / microbiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial
  • Female
  • Haemophilus influenzae* / drug effects
  • Haemophilus influenzae* / isolation & purification
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests*
  • Moraxella catarrhalis* / drug effects
  • Moraxella catarrhalis* / isolation & purification
  • Nasopharynx* / microbiology
  • Pneumococcal Vaccines* / administration & dosage
  • Prevalence
  • Staphylococcus aureus* / drug effects
  • Staphylococcus aureus* / isolation & purification
  • Streptococcus pneumoniae* / drug effects
  • Streptococcus pneumoniae* / isolation & purification
  • Uganda / epidemiology

Substances

  • Anti-Bacterial Agents
  • Pneumococcal Vaccines
  • 10-valent pneumococcal conjugate vaccine