Antibiotic resistance of Streptococcus pneumoniae colonising the nasopharynx of HIV-exposed Tanzanian infants

P Bles; Q de Mast; C E van der Gaast-de Jongh; G D Kinabo; G Kibiki; A van de Ven; M I de Jonge

doi:10.1111/tmi.12582

Antibiotic resistance of Streptococcus pneumoniae colonising the nasopharynx of HIV-exposed Tanzanian infants

Trop Med Int Health. 2015 Nov;20(11):1559-1563. doi: 10.1111/tmi.12582. Epub 2015 Sep 2.

Authors

P Bles¹, Q de Mast², C E van der Gaast-de Jongh^{1

3}, G D Kinabo⁴, G Kibiki⁵, A van de Ven², M I de Jonge^{1

3}

Affiliations

¹ Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
² Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
³ Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
⁴ Department of Pediatrics, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
⁵ Kilimanjaro Christian Medical University College, Kilimanjaro Clinical Research Institute, Moshi, Tanzania.

PMID: 26224321
DOI: 10.1111/tmi.12582

Abstract

Objectives: To determine antibiotic susceptibility of colonising pneumococcal serotypes in HIV-exposed infants before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), because HIV-exposed infants are at increased risk of invasive pneumococcal infections.

Methods: Antibiotic susceptibility of 104 pneumococcal isolates, cultured from the nasopharynx from Tanzanian HIV-exposed infants, was determined using the disc diffusion method and the E-test according to EUCAST version 4.0 (2014) criteria.

Results: A total of 69.2% of isolates were intermediately susceptible for benzyl penicillin (MIC 0.06-2 mg/l ); no high-level resistance was found. All isolates but one were susceptible to ampicillin. Regarding non-beta-lactam antibiotics, 19.2% of isolates were resistant to doxycycline, 3.8% to erythromycin and 97.1% to trimethoprim/sulfamethoxazole. A total of 15.4% of isolates were resistant to three antibiotic classes or more. There were no differences in antibiotic susceptibility between vaccine and non-vaccine serotypes. Reduced susceptibility of colonising pneumococcal isolates for commonly used antibiotics is common in HIV-exposed Tanzanian infants.

Conclusions: High-dose penicillin and ampicillin remain appropriate first choices for non-meningeal pneumococcal infections in this group.

Keywords: Streptococcus pneumoniae; HIV-exposed infants; Streptococcus pneumoniae; Tanzania; Tanzanie; antibiotic resistance; colonisation; colonización; niños expuestos al VIH; nourrissons exposés au VIH; resistencia antibiótica; résistance aux antibiotiques.