Andrew Mataya, Malawi
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi Pathogen Biology GroupAuthor Of 1 Presentation
ASSOCIATION BETWEEN PNEUMOCOCCAL CARRIAGE AND ANTIMICROBIAL ACTIVITY IN URINE OF MALAWIAN CHILDREN HOSPITALIZED WITH ACUTE RESPIRATORY INFECTION (ID 445)
Abstract
Background
Following the 2011 introduction of PCV13 in Malawi, 77% of healthy children carry pneumococci in the nasopharynx, while 41% of children hospitalized for acute respiratory infection (ARI) are colonized. We assessed if there is an association between pneumococcal carriage and pre-hospital antibiotic exposure.
Methods
Participants included 69 children aged 1-4 years admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi 2016-2019 due to ARI. Information on pre-hospital antibiotics was collected from parents and/or the child´s health passport. Antimicrobial activity was detected by a urine bioassay. Pneumococci were isolated from a nasopharyngeal sample and tested for antibiotic susceptibility.
Results
Among the 40/69 (58%) samples showing antibiotic activity, 6 (8.7%) were from children with no report of pre-hospital antibiotics. Pneumococci was isolated from 55% of children with urine antimicrobial activity, while carriage was 74% in children with no activity. No difference in pneumococcal penicillin susceptibility was found between children with or without urine antimicrobial activity.
Conclusions
The urine bioassay is a useful tool for assessment of antibiotic exposure in resource limited settings, since patient´s reported history may not be reliable. Pre-hospital antibiotics may explain lower pneumococcal carriage prevalence among those hospitalized compared to healthy. However, pre-hospital antibiotics have not selected for penicillin resistance.