Pneumococcal nasopharyngeal carriage among Bhutanese children hospitalized with clinical pneumonia: serotypes and viral co-infection
Por:
Jullien S, Sharma R, Lhamu Mynak M, Henares-Bonilla D, Munoz-Almagro C and Bassat Q
Publicada:
9 dic 2020
Ahead of Print:
9 dic 2020
Categoría:
Infectious diseases
Resumen:
BackgroundPneumococcal nasopharyngeal colonization (PNC) generally precedes pneumococcal disease. The purpose of this study was to determine the prevalence of PNC and to identify the pneumococcal serotypes circulating among Bhutanese children under five years of age admitted with clinical pneumonia, before the introduction of pneumococcal conjugate vaccine (PCV13) in the country. We also aimed to contribute to the understanding of the interplay between PNC and viral co-infection among this population.MethodsThis was a prospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital in Bhutan over 12 consecutive months. Children aged 2 to 59months admitted with WHO-defined clinical pneumonia were eligible for recruitment. We collected blood for bacterial culture and molecular identification of S. pneumoniae, and nasopharyngeal washing for screening of respiratory viruses, and for the detection and capsular typing of S. pneumoniae by real-time polymerase chain reaction (RT-PCR).ResultsOverall, 189 children were recruited, and PNC was tested in 121 of them (64.0%). PNC was found in 76/121 children (62.8%) and S. pneumoniae was identified in blood (both by culture and RT-PCR) in a single child. Respiratory viruses were detected in a similar proportion among children with (62/70; 88.6%) and without PNC (36/40; 90.0%; p=1.000), but rhinovirus detection was less common among children with PNC (20/70; 28.6% versus 19/40; 47.5%; p=0.046). Capsular typing identified 30 different serotypes. Thirty-nine children (51.3%) were colonised with two to five different serotypes. A third of the children presented with serotypes considered highly invasive. Over half of the children (44/76; 57.9%) were carrying at least one serotype included in PCV13.ConclusionsThis study provides baseline information on the status of PNC among Bhutanese children admitted with clinical pneumonia prior to the introduction of PCV13, which is valuable to monitor its potential impact. PCV13 could theoretically have averted up to 58% of the pneumococcal infections among the children in this study, suggesting a future role for the vaccine to significantly reduce the burden associated with S. pneumoniae in Bhutan.
Filiaciones:
Jullien S:
Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Sharma R:
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Lhamu Mynak M:
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Henares-Bonilla D:
Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain
CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain
Munoz-Almagro C:
Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain
CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain
Department of Medicine, Universitat Internacional of Catalunya, Barcelona, Spain
Bassat Q:
Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain
Instituciò Catalana de Recerca i Estudis Avancats, Barcelona, Spain
Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
Green Submitted, gold
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