Virginia Da Conceicao,
Author Of 2 Presentations
THE EFFECT OF ANTIBIOTIC USE ON NASOPHARYNGEAL CARRIAGE OF S. PNEUMONIAE IN A SURVEILLANCE STUDY OF HOSPITALISED CHILDHOOD PNEUMONIA AND MALNUTRITION IN DILI, TIMOR-LESTE (ID 1029)
Abstract
Background
Hospital-based surveillance of pneumonia is an emerging method for monitoring pneumococcal conjugate vaccine (PCV) effectiveness, especially in low resource settings like Timor-Leste. We assessed the impact of antibiotic use on nasopharyngeal carriage of S. pneumoniae (SPN).
Methods
Pulmaun Saudavel is an ongoing pre-PCV surveillance study of children 1-59 months hospitalised with pneumonia and/or malnutrition. Nasopharyngeal swabs were collected as soon as practical after admission and cultured. Antibiotic exposure was classified as prehospital (by parent report) and in-hospital (from the medical record).
Results
Of 160 cases enrolled between September 2019 and January 2020, 43 (26%) had NP carriage of SPN. Carriage was higher among cases without any antibiotic exposure (15/27, 56%), compared to those with any antibiotic exposure (28/133, 21%; p<0.01). While there was no difference in carriage between those with and without prehospital exposure (24% vs 30%, p=0.39), those with swab collected <12hrs after in-hospital exposure had higher carriage compared to those with swab collected >12hrs (50% vs 19%, p=0.034). This remained significant in a logistic regression adjusted for age and sex (p=0.047).
Conclusions
Antibiotic exposure is associated with reduced NP carriage of SPN. Hospital-based studies should attempt to collect NP swabs within 12 hours of first antibiotic dose.
NASOPHARYNGEAL CARRIAGE OF S. PNEUMONIAE IN CHILDREN SEVERE ACUTE MALNUTRITION (SAM) AND/OR PNEUMONIA: PRELIMINARY FINDINGS FROM A SURVEILLANCE PROJECT AT THE DILI NATIONAL HOSPITAL, TIMOR-LESTE (ID 1172)
Abstract
Background
Children with SAM have impaired immune function (including mucosal defences) and an increased risk of pneumococcal pneumonia. We evaluated if SAM was associated with increased nasopharyngeal carriage of S. pneumoniae (Spn).
Methods
Pulmaun Saudavel is an ongoing surveillance study of children aged 1-59 months hospitalised with SAM and/or pneumonia in Dili, Timor-Leste, where no pneumococcal conjugate vaccine (PCV) is in use. SAM is defined according to World Health Organization (WHO) criteria. Pneumonia is defined as cough or difficulty breathing and any one of: respiratory rate >50bpm, oxygen saturation <90%, lower chest wall indrawing, or WHO-defined radiological pneumonia. NP swabs are collected after admission and processed according to WHO guidelines.
Results
Of 160 cases enrolled to date, 103 (64%) had pneumonia, 27 (17%) SAM, and 30 (19%) both pneumonia and SAM. Overall NP carriage of Spn was 27% (43/160). There was no difference in carriage between SAM cases (15/57, 26%) and pneumonia-only cases (27/97, 28%). Among children with SAM, those with pneumonia had higher carriage (11/30, 37%) compared to those without pneumonia (4/27, 15%; p=0.08).
Conclusions
Pneumonia is a common complication of SAM and may be associated with increased Spn carriage. PCV use in Timor-Leste is likely to benefit children with SAM.