Nasopharyngyeal Carriage and Antimicrobial Susceptibility of Streptococcus pneumoniae, in Children under Five Years at Mbarara Regional Referral Hospital, Uganda

Abstract

Background: Acute respiratory infections (ARI) are a leading cause of childhood morbidity and mortality, causing 25-30% of all deaths in developing countries. Pneumococcal disease is a significant public health problem that usually follows pneumococcal colonization of the nasopharynix. We determined the prevalence of nasopharyngeal carriage of Streptococcus pneumoniae, antimicrobial susceptibility patterns and risk factors for nasopharyngeal carriage of S. pneumoniae among under fives attending Maternal Child Health Clinic at Mbarara Regional Referral Hospital (MRRH). Methods: We performed a cross-sectional study between August and November 2012. Nasopharyngeal swabs collected from four hundred healthy children were cultured on blood agar and chocolate agar and incubated for 24 hours at 37⁰C in carbon dioxide jar. Upon growth the organisms were identified by colonial appearance and standard biochemical tests. Antimicrobial resistance to six antibiotics was performed using Kirby Bauer method on chocolate agar and interpreted according to CLSI guide lines. Results: The prevalence of S. pneumoniae in the cultured samples was reported at 19% (76/400). Of the positive isolates, 75/76 (99%) and 55/76 (77%) were shown to be resistant to cotrimoxazole and tetracycline, respectively. Among the factors assessed for nasopharyngeal carriage of S. pneumoniae none was significantly associated with carriage. Conclusion: Despite the low rate of carriers of S. pneumoniae, a remarkable resistance of these isolates to cotrimoxazole and tetracycline was detected.