Background
This study assessed whether nasopharyngeal isolates of Streptococcus pneumoniae from hospitalized children in rural Gambia could be used to predict the prevalence of antimicrobial resistance of strains that cause invasive pneumococcal diseases.
Method
Population-based surveillance for pneumonia, septicaemia, and meningitis was conducted among children under 5 years in a rural area of The Gambia under demographic surveillance from September 2019 to December 2023. Nasopharyngeal swabs (NPS), blood cultures, cerebrospinal fluid and lung aspirates were collected. Conventional microbiology, kirby-Bauer disc diffusion method and descriptive statistic was use to determine the isolation, antibiotic susceptibility pattern and the proportion of AMR.
Result
Of the 49 IPD cases detected with homologous NPS collected, S. pneumoniae was isolated in 45 (91.8%) NPS cultures. Of the paired IPD and NPS homologous S. pneumoniae samples, 19 (42.2%) of oxacillin, 0 (0%) of chloramphenicol, 23 (51.1%) of tetracycline, 42 (93.3%) of trimethoprim-sulfamethoxazole, 40 (88.9%) of vancomycin and 0 (0%) of ceftriaxone showed resistance in NPS samples. 23 (51.1%) of oxacillin, 2 (4.4%) of chloramphenicol, 26 (57.8%) of tetracycline, 45 (100%) of trimethoprim-sulfamethoxazole, 5 (11.1%) of vancomycin and 0 (0%) of ceftriaxone demonstrated resistance in invasive samples.
Discussion
The proportions of AMR of S. pneumoniae isolates from invasive samples and NPS were comparable. These findings demonstrate that nasopharyngeal isolates of S. pneumoniae from children with suspected pneumonia may be considered as a tool to monitor for AMR in a defined setting. This tool will enable a rational and effective use of antibiotics in the clinical management of IPD.