Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

  • Cissy B. Kartasasmita Departments of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Heda Melinda Duddy Departments of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Sunaryati Sudigdoadi Microbiology, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Dwi Agustian The Research Unit, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Ina Setiowati The Research Unit, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Tri Hanggono Ahmad The Research Unit, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
  • Ramdan Panigoro The Research Unit, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
Keywords: community acquired pneumonia, nasopharyngeal carriage, S. pneumoniae, antimicrobial resistance

Abstract

Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP) swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines), were included in the study. Nasopharyngeal swabs (CDC/WHO Manual) were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.

References

1. Turner RB, Lande AE, Chase P, Hilton N, Weinberg D. Pneumonia in pediatric outpatients: Cause and clinical manifestations. J Pediatr 1987;111:194-200
2. World Health Organization (WHO). Manual for the National Surveillance of antimicrobial resistance of S pneumoniae and H influenzae: Epidemiologycal and microbiological methods, WHO Geneva and CDC Atlanta, 1994
3. Harris JS. Antimicrobial therapy of pneumonia in infants and children. Semin Respir Infect 1996; 11:139-47.
4. Shann F, Woolcock A, Black R, Cripps A, Foy H, Harris M, D’Souza R. Introduction: Acute respiratory infections – The forgotten Pandemic. CID 1999; 28:189- 91.
5. Shann F. Etiology of severe pneumonia in children in developing countries. Pediatr Infect Dis J 1986;5:247-52.
6. Schidlow DV, Callahan CW. Pneumonia. Pediatr Rev 1996:17:300-9.
7. De Valk H. Surveillance of respiratory bacteria drug resistance. Seminar ARI, Ciloto, 1996.
8. World Health Organization (WHO). Programe for the control of acute respiratory infections. Surveillance of respiratory bacteria drug resistance, 1995
9. Gessner BD, Sutanto A, Steinhoff M, Soewignjo S, Widjaya A, Nelson C, Arjoso S. Population-based survey of Haemophilus influenzae type b nasopharyngeal carriage prevalence in Lambok Island, Indonesia. Pediatr Infect Dis J 1998;17:S179-82
10. Pechere JC. Editor. Community acquired pneumonia in children. International forum series. Cambridge Medical Publications, 1995
11. World Health Organization (WHO). Antibiotics in the treatment of acute respiratory infections in young children. 1990;10:2
12. Qazi SA. Antibiotic strategies for developing countries: Experience with acute respiratory infections in Pakistan. CID 1999; 28:214-8
Published
2001-12-31
How to Cite
1.
Kartasasmita C, Duddy H, Sudigdoadi S, Agustian D, Setiowati I, Ahmad T, Panigoro R. Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia. PI [Internet]. 31Dec.2001 [cited 29Mar.2024];41(11-12):292-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1045
Received 2016-11-17
Accepted 2016-11-17
Published 2001-12-31