Risk factors associated with Streptococcus pneumonia carriage in children under five years old with acute respiratory infection in Niger

Prevalence, Antimicrobial Drug Resistance and Associated Risk Factors of Streptococcus Pneumoniae Bacteria Infection Among Under-Five Children With Acute Lower Respiratory Tract Infection Attending Sheik Hassan Yebere Referral Hospital, Jig-Jiga, Ethiopia

Background

Pneumonia is inflammation of the lung. The Streptococcus pneumoniae (S. pneumoniae) is commensal in the upper airway and can cause infection to under-five children. The bacteria is gram-positive diplococci, catalase negative, and optochin sensitive. The bacteria is the leading cause of bacterial pneumonia among under-five children. No similar data is reported from the current study area.

Objective

To determine prevalence, antimicrobial drug resistance and associated factors of S. pneumoniae infection among under-five children with acute lower respiratory tract infection attending Sheck Hassan Yebere Referral Hospital from March 1 to April 30, 2021 Jig-Jiga, Ethiopia.

Methods

A cross-sectional study was conducted among 374 study participants selected by convenience sampling method. A structured questionnaire was used to collect child data. Nasopharyngeal/oropharyngeal swabs were collected and diagnosed to isolate S. pneumoniae by using culture then identified by biochemical examination. Later antimicrobial drug resistance testing was performed by Kirby-Bauer disk diffusion method. All data were entered on epi-data 3.1 then exported to SPSS version 22 to calculate analysis. Statistically significant value was found by calculating an adjusted odds ratio with p-value ≤ 0.05 in a multivariate logistic regression model.

Results

Among 374 under-five children, 180 (48.1%) were males and 109 (29.2%) were from low income families. The overall prevalence of S. pneumoniae infection in the study was 18% (95% CI 14.4-22.2). No window (AOR=2.8 CI 1.1-7.6), no/non-exclusive breast-feeding (AOR= 2.1 CI 1.1-4.1), and previous URTI (AOR= 3.2 CI 1.7-6.1) were significantly associated with S. pneumoniae infection. The isolated organism showed drug resistance for Cotrimoxazole (35%), and Tetracycline (34%).

Conclusion

The prevalence and antimicrobial resistance in this study were comparatively high. No window, non-exclusive breast-feeding and previous URTI were associated with S. pneumoniae infection. The isolated S. pneumoniae showed high drug resistance to cotrimoxazole and tetracycline.

High incidence of the virus among respiratory pathogens in children with lower respiratory tract infection in northwestern China

Lower respiratory tract infection (LRTI) is one of the major reasons for childhood mortality that threaten the health of the public. We aimed to investigate the epidemiological pathogens and their infection analysis among children with LRTI. Sputum specimens were collected for polymerase chain reaction detection and microbiological tests to identify the viral infection and bacterial infection. The serological specimens were separated from venous blood using for Mycoplasma pneumoniae and Chlamydia pneumoniae detection. The virus was confirmed in 86.2% of the children. Human rhinovirus (38.3%), respiratory syncytial virus (32.1%), and parainfluenza virus type 3 (27.2%) were the most frequently identified pathogens. Patients with viral and bacterial coinfection showed younger age (p = 0.032), a higher proportion of wheezing rales (p = 0.032), three depressions sign (p = 0.028), and tachypnea (p = 0.038), and more likely associated with severe pneumonia (p = 0.035). Additionally, older children were more susceptible to viral-atypical bacterial coinfection (p = 0.032). Vomiting (p = 0.011) and fever (p = 0.003) were more likely to occur in children with viral-atypical bacterial coinfection. Attention should be paid to the virus infection of LRTI, as viral-bacterial coinfection and viral-atypical bacterial co-infection may have a detrimental impact on the gravity of LTRI.

Physical Home Sanitation as a Risk Factor for Acute Respiratory Infection in Children under 5 at Labuan Regency, Central Sulawesi

Objective: The purpose of this study was to determine the risk of physical home sanitation against acute respiratory infections in children under five in Labuan Regency, Central Sulawesi. Method: This study was done in Labuan District, Donggala Regency, from July 31 to October 28, 2021, as an observational study with a Case Control Study technique. All children under the age of five who have ARI in the Labuan Health Center Work Area, Labuan District, Donggala Regency, are included in the study. The research was approved by the Makassar Ministry of Health Poltekkes Ethics Committee Number 1068/KEPK-PTKMKS/IX/2020 on the basis of its ethical feasibility. Results: The physical sanitation condition of the house that does not meet the requirements for dust content is 52.9%. Home ventilation 58.6%. The lighting conditions are 47.1% and the humidity of the house is 35.7%. Bivariate analysis showed that there was a relationship between dust levels and the incidence of ARI (p=0.000), ventilation conditions with the incidence of ARI (p=0.000), lighting with the incidence of ARI (p=0.001) and humidity with the incidence of ARI (p=0.005) in children. in Labuan District, Donggala Regency. The incidence of ARI is more common in children aged 0-2 years, and the incidence of ARI has no difference between male and female sexes. Multivariate analysis showed that dust content (p=0.000 CI95% OR=9.56) and ventilation (p=0.001 CI95% OR=6.08) were the main variables that caused ARI in children in Labuan District, Donggala Regency. Conclusion: The main variables causing ARI in children in Labuan District, Donggala Regency are dust content (OR = 9.56) and ventilation (OR = 6.08)

Nasopharyngeal colonisation dynamics of bacterial pathogens in patients with fever in rural Burkina Faso: an observational study

Background

Nasopharyngeal colonisation with clinically relevant bacterial pathogens is a risk factor for severe infections, such as pneumonia and bacteraemia. In this study, we investigated the determinants of nasopharyngeal carriage in febrile patients in rural Burkina Faso.

Methods

From March 2016 to June 2017, we recruited 924 paediatric and adult patients presenting with fever, hypothermia or suspicion of severe infection to the Centre Medical avec Antenne Chirurgicale Saint Camille de Nanoro, Burkina Faso. We recorded a broad range of clinical data, collected nasopharyngeal swabs and tested them for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Klebsiella pneumoniae by quantitative polymerase chain reaction. Using logistic regression, we investigated the determinants of carriage and aimed to find correlations with clinical outcome.

Results

Nasopharyngeal colonisation with S. pneumoniae, H. influenzae and M. catarrhalis was highly prevalent and strongly dependent on age and season. Females were less likely to be colonised with S. pneumoniae (OR 0.71, p = 0.022, 95% CI 0.53–0.95) and M. catarrhalis (OR 0.73, p = 0.044, 95% CI 0.54–0.99) than males. Colonisation rates were highest in the age groups < 1 year and 1–2 years of age and declined with increasing age. Colonisation also declined towards the end of the rainy season and rose again during the beginning of the dry season. K. pneumoniae prevalence was low and not significantly correlated with age or season. For S. pneumoniae and H. influenzae, we found a positive association between nasopharyngeal carriage and clinical pneumonia [OR 1.75, p = 0.008, 95% CI 1.16–2.63 (S. pneumoniae) and OR 1.90, p = 0.004, 95% CI 1.23–2.92 (H. influenzae)]. S. aureus carriage was correlated with mortality (OR 4.01, p < 0.001, 95% CI 2.06–7.83), independent of bacteraemia caused by this bacterium.

Conclusions

Age, sex and season are important determinants of nasopharyngeal colonisation with S. pneumoniae, H. influenzae and M. catarrhalis in patients with fever in Burkina Faso. S. pneumoniae and H. influenzae carriage is associated with clinical pneumonia and S. aureus carriage is associated with mortality in patients with fever. These findings may help to understand the dynamics of colonisation and the associated transmission of these pathogens. Furthermore, understanding the determinants of nasopharyngeal colonisation and the association with disease could potentially improve the diagnosis of febrile patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06996-7.

Carriage of Streptococcus pneumoniae in children under five years of age prior to pneumococcal vaccine introduction in Southeast Asia: A systematic review and meta-analysis (2001-2019)

A number of pneumococcal carriage studies in children have been conducted in recent years. However, summary data of carriage prevalence and serotype distribution from South East Asia Region (SEAR) are limited. This may lead to the misconception that Streptococcus pneumoniae vaccine-types are uncommon in the region. Systematic reviews of pneumococcal carriage and the distribution of serotypes are critically important for evidence-based decision-making. We aimed to summarize published data on the serotype prevalence of S. pneumoniae carried in the nasopharynx of children under 5 years of age in SEAR. We performed a systematic review and meta-analysis for relevant studies on S. pneumoniae carriage conducted prior to PCV program implementation from online journal databases published between January 2001 to December 2019. The pooled prevalence of S. pneumoniae in healthy children under 5 years of age in SEAR was 36.0% (95% CI 34.2%-37.8%), and ranged from 68.0% (95% CI: 61.9%-74.0%) in Cambodia to 7.6% (95% CI: 5.7%-9.6%) in Malaysia. Serotypes 6A/B, 23F and 19F were the most common serotypes in children <5 years, accounting for 12.9% (95% CI: 9.4%-16.3%), 9.3% (95% CI: 5.9%-12.8%) and 10.1% (95% CI: 6.6%-13.5%) of isolates, respectively. Vaccine policy makers should take these results into account when making decisions on pneumococcal conjugate vaccine programs implementation. Given the paucity of data, collection of more extensive and updated information of S. pneumoniae serotype epidemiology in children under five years in SEAR is also very important for future studies.