Background

Streptococcus pneumoniae is a bacterial pathogen that colonizes the human nasopharynx. Colonization is frequently reported to be high in young children. In this study, we investigated the nasopharyngeal (NP) carriage rate, serotype distribution, and antibiotic susceptibility of S. pneumoniae in children under five years of age in Kotabaru, South Kalimantan, Indonesia.

Methods

NP swab specimens were collected from 399 young children (mean age: 30 months) who participated in the Rampa Village Community Health Center, with 74% of the participants being Bajau children. S. pneumoniae was identified using optochin susceptibility and bile solubility tests. Serotyping was performed by sequential multiplex PCR, and antimicrobial susceptibility profiling was performed by disk diffusion and microdilution methods.

Results

The NP carriage rate of S. pneumoniae was 45% (180/399). The most commonly serotypes were 6A/6B (18%), followed by 15B/15C (17%), 19F (16%), 34 (8%), and 23F (5%); 46% of them were identified as strains of the PCV13 vaccine type. Additionally, almost half of the pneumococcal isolates were non-susceptible to penicillin (40%), whereas non-susceptibility to tetracycline (36.8%), trimethoprim/sulfamethoxazole (29.7%), erythromycin (16.8%), chloramphenicol (9.7%), and clindamycin (8.6%) was also found. We identified 18% (n = 34) of S. pneumoniae isolates as multidrug-resistant (MDR) strains, and serotype 19F was the most common (74%) among them.

Conclusions

MDR S. pneumoniae vaccine type strains were dominated by serotype 19F. The implementation of a pneumococcal conjugate vaccine program in Indonesia might reduce MDR strains circulating in the community in the future.

中文翻译：

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印度尼西亚南加里曼丹省哥打巴鲁从 5 岁以下儿童中分离出的肺炎链球菌的鼻咽携带率、血清型分布和抗菌药物敏感性特征

背景

肺炎链球菌是一种寄生于人类鼻咽部的细菌病原体。据报道，儿童的定植率很高。在这项研究中，我们调查了印度尼西亚南加里曼丹省哥打巴鲁五岁以下儿童肺炎链球菌的鼻咽 (NP) 携带率、血清型分布和抗生素敏感性。

方法

NP 拭子样本是从参加 Rampa 村社区健康中心的 399 名幼儿（平均年龄：30 个月）中收集的，其中 74% 的参与者是巴瑶族儿童。使用 optochin 敏感性和胆汁溶解度测试鉴定了肺炎链球菌。通过连续多重 PCR 进行血清分型，通过磁盘扩散和微量稀释方法进行抗菌药物敏感性分析。

结果

肺炎链球菌的NP携带率为45%（180/399）。最常见的血清型是 6A/6B (18%)，其次是 15B/15C (17%)、19F (16%)、34 (8%) 和 23F (5%)；其中 46% 被鉴定为 PCV13 疫苗类型的毒株。此外，几乎一半的肺炎球菌分离株对青霉素不敏感（40%），而对四环素（36.8%）、甲氧苄啶/磺胺甲恶唑（29.7%）、红霉素（16.8%）、氯霉素（9.7%）、还发现了克林霉素（8.6%）。我们将 18% (n = 34) 的肺炎链球菌分离株鉴定为耐多药 (MDR) 菌株，其中血清型 19F 是最常见的 (74%)。

结论

MDR肺炎链球菌疫苗型菌株以血清型 19F 为主。在印度尼西亚实施肺炎球菌结合疫苗计划可能会减少未来在社区中传播的耐多药菌株。