Journal Article

Nasopharyngeal Carriage of <i>Streptococcus pneumoniae</i> in Gambian Villagers

Philip C. Hill, Abiodun Akisanya, Kawsu Sankareh, Yin Bun Cheung, Mark Saaka, George Lahai, Brian M. Greenwood and Richard A. Adegbola

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 6, pages 673-679
Published in print September 2006 | ISSN: 1058-4838
Published online September 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/506941
Nasopharyngeal Carriage of Streptococcus pneumoniae in Gambian Villagers

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Background. To prepare for the introduction of a pneumococcal conjugate vaccine of restricted valency, we studied the nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers.

Methods. A cross-sectional survey was conducted in 21 villages after a census. We recorded demographic characteristics, information on medical history, and data on possible risk factors for carriage from subjects. We collected a nasopharyngeal swab specimen from each subject for isolation and serotyping of S. pneumoniae and for antibiotic susceptibility testing.

Results. The prevalence of S. pneumoniae carriage among 2872 villagers was 72%. It was highest among infants (i.e., children aged <1 year; 97%); the rate was 93% among babies aged <1 month and decreased with increasing age (P < .001). Prevalence of carriage was linked to proximity to another village. Sixty-three percent of isolates recovered from children aged <5 years were covered by the 7-valent vaccine or were of a vaccine-related serotype, compared with 43% of isolates overall. Forty-three isolates (14.3%) tested were initially penicillin resistant; none had high-level resistance, and 4 had intermediate resistance. The rates of resistance to other antibiotics were as follows: trimethoprim-sulfamethoxazole, 39%; tetracycline, 32.3%; chloramphenicol, 6.3%; cefotaxime, 0.3%; and erythromycin, 0%. The rates were highest for isolates of vaccine serotypes.

Conclusions. Pneumococcal carriage rates among Gambian villagers are very high. A pneumococcal conjugate vaccine of restricted valency should reduce the pool of antibiotic-resistant pneumococci. The large reservoir of pneumococci of nonvaccine serotypes will require close monitoring when the vaccine is introduced.

Journal Article.  4342 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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