Background: Children with sickle cell disease (SCD) are susceptible to invasive bacterial infections, particularly those caused by Streptococcus pneumoniae. Data concerning nasopharyngeal carriage remain scarce in this population at high risk of resistant bacteria owing to antibiotic pressure and frequent hospitalizations.
Methods: We conducted this prospective trial, DREPANOBACT, in 7 French hospitals to assess the nasopharyngeal carriage rate for S. pneumoniae among children with SCD aged 6 months-15 years between September 2022 and April 2024. The secondary aim was to determine the serotype distribution and proportion of penicillin nonsusceptible S. pneumoniae isolates and the carriage and antibiotic resistance rates for Staphylococcus aureus, Moraxella catarrhalis and Haemophilus influenzae.
Results: In total, 300 children were enrolled [median age, 8 years (interquartile range: 4-12 years)]. S. pneumoniae carriage accounted for 32 cases (11%), including 21 penicillin nonsusceptible S. pneumoniae strains (66%). The main serotypes were 23A (n = 4), 35B (n = 4), 11A (n = 3) and 15C (n = 3). Overall, 75% of the serotypes were non-13-valent pneumococcal conjugate vaccine (PCV) serotypes, with 19% and 53% covered by PCV20 and PCV21, respectively. The carriage rates for S. aureus, M. catarrhalis and H. influenzae were 31%, 17% and 11%, respectively. Methicillin resistance was observed in 5% of S. aureus strains. Age ≤5 years was significantly associated with S. pneumoniae, M. catarrhalis, and H. influenzae carriage, while age ≥11 years was associated with S. aureus carriage.
Conclusions: Surveillance of nasopharyngeal carriage in children with SCD is warranted to monitor changes in predominant serotypes and resistance patterns.
Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.