Nasopharyngeal Carriage and Antibiogram of Pneumococcal and Other Bacterial Pathogens from Children with Sickle Cell Disease in Tanzania

Ritah F Mutagonda; George Bwire; Raphael Zozimus Sangeda; Manase Kilonzi; Hamu Mlyuka; Joyce Ndunguru; Agnes Jonathan; Julie Makani; Irene Kida Minja; Paschal Ruggajo; Emmanuel Balandya; Appolinary A R Kamuhabwa

doi:10.2147/IDR.S367873

Nasopharyngeal Carriage and Antibiogram of Pneumococcal and Other Bacterial Pathogens from Children with Sickle Cell Disease in Tanzania

Infect Drug Resist. 2022 Aug 10:15:4407-4418. doi: 10.2147/IDR.S367873. eCollection 2022.

Authors

Ritah F Mutagonda^{1

2}, George Bwire³, Raphael Zozimus Sangeda^{2

3}, Manase Kilonzi¹, Hamu Mlyuka¹, Joyce Ndunguru^{2

4}, Agnes Jonathan^{2

4}, Julie Makani^{2

4}, Irene Kida Minja^{2

5}, Paschal Ruggajo^{2

6}, Emmanuel Balandya^{2

7}, Appolinary A R Kamuhabwa¹

Affiliations

¹ Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
² Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
³ Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
⁴ Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
⁵ Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
⁶ Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
⁷ Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.

Abstract

Background: Bacterial infections contribute significantly to morbidity and mortality in sickle cell disease (SCD) patients, particularly children under five years of age. In Tanzania, prophylaxis against pneumococcal infection among children with SCD advocates the use of both oral penicillin V (PV) and pneumococcal vaccines (PNV). Therefore, this study aimed to investigate nasopharyngeal carriage and antibiogram of Streptococcal pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) in children with SCD in Tanzania.

Methods: This cross-sectional study was undertaken at the two Sickle Pan-African Research Consortium (SPARCO) study sites in Dar es salaam, Tanzania. The study was conducted for six months and enrolled children with SCD between the ages of 6 to 59-months. A semi-structured questionnaire was used to collect patient data. Nasopharyngeal swabs were collected from all participants and cultured for Streptococcal pneumoniae and other bacterial isolates. Antimicrobial susceptibility tests of the isolates were done using the disc diffusion method.

Results: Out of 204 participants, the overall prevalence of bacterial carriage was 53.4%, with S. aureus (23.5%), coagulase-negative Staphylococci (CoNS) (23%) and S. pneumoniae (7.8%) being commonly isolated. In antibiotic susceptibility testing, S. aureus isolates were most resistant to penicillin (81.8%), whereas 81.3% of S. pneumoniae isolates were resistant to co-trimoxazole. The least antimicrobial resistance was observed for chloramphenicol for both S. aureus and S. pneumoniae isolates (6.3% versus 0%). The proportion of multi-drug resistance (MDR) was 66.7% for S. aureus isolates and 25% for S. pneumoniae isolates.

Conclusion: There are substantially high nasopharyngeal carriage pathogenic bacteria in children with SCD in Dar es Salaam, Tanzania. The presence of MDR strains to the commonly used antibiotics suggests the need to reconsider optimizing antimicrobial prophylaxis in children with SCD and advocacy on pneumococcal vaccines.

Keywords: antimicrobial resistance; bacterial pathogens; pneumococcal carriage; pneumococcal prophylaxis.

Abstract

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