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ABSTRACT
Introduction
Despite the availability of effective antimicrobials and vaccines, Streptococcus pneumoniae remains a major public health problem in children under five years old in the world. Pneumococcal carriage is believed to be an important source of the horizontal spread of this pathogen within the community, particularly in areas where there are crowded living conditions, like schools and daycare centers. The resistance of Streptococcus pneumoniae to antibiotics is gradually becoming a serious problem.
Objective
This study aimed to assess the prevalence of nasopharyngeal carriage and antimicrobial susceptibility pattern of Streptococcus pneumoniae among preschool children in Gondar town, North West Ethiopia.
Methods
A cross-sectional study was conducted from January to March 2018. A total of 401 children aged1-6 years old attending daycare centers and kindergartens in Gondar town were selected using a multistage sampling technique. Nasopharyngeal swabs were collected and inoculated into appropriate media. Identification of Streptococcus pneumoniae was performed using Gram stain, optochin test, and bile solubility test. Antimicrobial sensitivity tests were done using a modified Kirby-Bauer disk diffusion method. Data were entered into the EpiData 3.1 software and analyzed using SPSS version 20. P-value < 0.05 at 95% CI was considered statistically significant.
Results
The overall carriage rate of Streptococcus pneumoniae was 23.2%. Among the tested antibiotics, 83.9% of the isolates were non-susceptible to trimethoprim-sulfamethoxazole, 33.3% to erythromycin, 27.9% to penicillin, and 24.7% to tetracycline. Multidrug resistance was detected in 17 (18.3 %) isolates. In multivariate logistic regression analysis, young age and passive smoking were associated with pneumococcal carriage.
Conclusions
This study revealed a substantially low prevalence of Streptococcus pneumoniae nasopharyngeal carriage. High antimicrobial resistance was observed for most antimicrobial drugs tested. The younger age group and passive smokers were at risk of Streptococcus pneumoniae nasopharyngeal carriage.
Keywords: Streptococcus Pneumoniae; Antimicrobial Susceptibility; Preschool Children; Nasopharyngeal Carriage; Ethiopia