High prevalence of antibiotic resistance in nasopharyngeal bacterial isolates from healthy children in rural Uganda: A cross-sectional study
Autor: | Edison Mworozi, Betty Mpeka, Freddie Bwanga, Stefan Peterson, George Pariyo, Elizeus Rutebemberwa, Karin Källander |
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Rok vydání: | 2015 |
Předmět: |
Pediatrics
medicine.medical_specialty Antibiotic resistance Cross-sectional study Population Microbial Sensitivity Tests Drug resistance medicine.disease_cause Risk Assessment community case management children Nasopharynx Streptococcus pneumoniae Prevalence medicine Humans Mass Screening pneumonia Uganda education Mass screening education.field_of_study business.industry Infant Drug Resistance Microbial Original Articles General Medicine Pneumonia Pneumococcal medicine.disease Anti-Bacterial Agents Cross-Sectional Studies Carriage Child Preschool Carrier State business Malaria |
Zdroj: | Upsala Journal of Medical Sciences |
ISSN: | 2000-1967 0300-9734 |
Popis: | Background: In Uganda, the main causes of death in children under 5 years of age are malaria and pneumonia—often due to delayed diagnosis and treatment. In preparation for a community case management intervention for pneumonia and malaria, the bacterial composition of the nasopharyngeal flora and its in vitro resistance were determined in children aged five or under to establish baseline resistance to commonly used antibiotics. Methods: In a population-based survey in April 2008, nasopharyngeal specimens were collected from 152 randomly selected healthy children under 5 years of age in the Iganga/Mayuge Health and Demographic Surveillance Site (HDSS). Medical history and prior treatment were recorded. Demographic characteristics and risk factors for carriage of resistant strains were obtained from the HDSS census. Bacteria were isolated and analysed for antibiotic susceptibility using disk diffusion and E test. Results: Streptococcus pneumoniae (S. pneumoniae) carriage was 58.6%, and, while most (80.9%) isolates had intermediate resistance to penicillin, none was highly resistant. Whereas no isolate was resistant to erythromycin, 98.9% were resistant to trimethoprim-sulphamethoxazole (co-trimoxazole). Conclusions: In vitro resistance in S. pneumoniae to co-trimoxazole treatment was high, and the majority of isolates had intermediate resistance to penicillin. To inform treatment policies on the clinical efficacy of current treatment protocols for pneumonia in health facilities and at the community level, routine surveillance of resistance in pneumonia pathogens is needed as well as research on treatment efficacy in cases with resistant strains. Improved clinical algorithms and diagnostics for pneumonia should be developed. |
Databáze: | OpenAIRE |
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