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Open Access Highly Accessed Research article

Penicillin resistance and serotype distribution of Streptococcus pneumoniae in Ghanaian children less than six years of age

Nicholas TKD Dayie12, Reuben E Arhin1, Mercy J Newman1, Anders Dalsgaard2, Magne Bisgaard2, Niels Frimodt-Møller3 and Hans-Christian Slotved4*

  • * Corresponding author: Hans-Christian Slotved hcs@ssi.dk

Author Affiliations

1 Department of Microbiology, University of Ghana Medical School, Accra, Ghana

2 Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

3 Department of Clinical Microbiology, University Hospital, Hvidovre, Copenhagen, Denmark

4 Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark

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BMC Infectious Diseases 2013, 13:490  doi:10.1186/1471-2334-13-490

Published: 22 October 2013

Abstract

Background

The objective of this study was to determine the prevalence of nasopharyngeal carriage, serotype distribution, and penicillin resistance of Streptococcus pneumoniae in children ≤6 years of age in Ghana.

Methods

A cross-sectional study was carried out on a cluster-randomized sample of children ≤6 years of age attending nurseries and kindergartens in Accra and Tamale, Ghana. Basic data on age, sex and exposure to antimicrobials in the previous month were collected on all study subjects. Nasopharyngeal swabs were obtained from participants and all pneumococcal isolates were characterized by serotyping and their penicillin resistance determined.

Results

The overall prevalence of pneumococcal carriage among the children was 34% in Accra and 31% in Tamale. The predominant serotypes were 19F, 6B, 23F, and 6A with 23% of the isolates being non-typable in Accra and 12% in Tamale. Only two isolates (serotypes 19F and 6B) from Tamale had a MIC >2 μg/ml and were classified as fully penicillin resistant with 45% of the isolates having intermediate resistance.

Conclusions

These findings indicate that the 13-valent pneumococcal conjugate vaccine (PCV-13) recently introduced in Ghana will cover 48% and 51% of the serotypes identified in Accra and Tamale, respectively. The 23-valent pneumococcal polysaccharide vaccine (PPV-23) will cover 54% of all serotypes detected. The two penicillin resistant isolates (MIC 32 μg/ml) were serotypes included in both PCV-13 and PPV-23. A nationwide monitoring system of penicillin susceptibility patterns and pneumococcal serotypes is recommended.