Nelson Tembe, Mozambique
Centro de Investigacacao em saude de Manhica acute respiratory and invasive bacterial infections unitAuthor Of 1 Presentation
HIGH CARRIAGE PREVALENCE OF ANTIMICROBIAL-NON-SUSCEPTIBLE PNEUMOCOCCI IN CHILDREN WITH RADIOLOGICALLY CONFIRMED PNEUMONIA THREE YEARS AFTER 10-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV10) INTRODUCTION IN MOZAMBIQUE (ID 996)
- Benild Moiane, Mozambique
- Fernanda Lessa, United States of America
- Sergio Massora, Mozambique
- Helio B. Mucavele, Mozambique
- Alberto Chauque, Mozambique
- Fabiana Pimenta, United States of America
- Cynthia G. Whitney, United States of America
- Benard Beall, United States of America
- Nelson Tembe, Mozambique
- Maria G. Carvalho, United States of America
- Betuel Sigauque, Mozambique
Abstract
Background
Antimicrobial resistance (AR) is a global problem, and drug-resistant pneumococci are a serious AR threat. We evaluated carriage of antimicrobial non-susceptible pneumococci in children with X-ray confirmed pneumonia (XRCP) 3 years after PCV10 introduction in Mozambique.
Methods
We collected nasopharyngeal swabs from children who were age-eligible for PCV and hospitalized with XRCP at 3 hospitals (2 urban, 1 rural) in southern Mozambique between October 2015-May 2016. Specimens were cultured for pneumococci; isolates underwent serotyping by Quellung and antimicrobial susceptibility testing using broth microdilution. Non-susceptible isolates had intermediate or full resistance based on CLSI 2018 breakpoints; multi-drug non-susceptible (MDNS) isolates were non-susceptible to ≥3 antimicrobial classes.
Results
Pneumococci were detected in 90 (42.1%) of 214 children with XRCP. Of those, 28.9% (26/90) and 81.1% (73/90) carried PCV10-type and penicillin-non-susceptible pneumococci, respectively. Among 29 (32%) children colonized with MDNS-pneumococci, serotypes 23F (27.6% [n=8]) and 19F (17.2% [n=5]) were most prevalent. PCV10-types were more associated with penicillin-non-susceptibility (100% vs. 73.4%, P=0.002) and MDNS (69.7% vs. 17.2%, P<.001) than non-PCV10-types. Non-susceptibility to 3rd generation cephalosporins was found in two 19F isolates.
Conclusions
High prevalence of penicillin-non-susceptible and MDNS-vaccine-type pneumococcal carriage among children with pneumonia post-PCV10 introduction in Mozambique is concerning and suggests new prevention strategies are needed.