SOVREMENNAYA PEDIATRIYA.2016.6(78):68-74; doi 10.15574/SP.2016.78.68 

Pneunococcal Serotypes in Nasopharyngeal Carriage and Meningitis, Their Susceptibility to Antibiotics in Children 

Chernyshova L. I., Gilfanova A. M., Bondarenko A. V., Yanovska V. V., Glushkevich G. G., Yakimovich S. A.

Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Bacteriological Laboratory SI «Ukrainian Center for Diseases Control and Monitoring of the Ministry of Health of Ukraine» Kyiv, Ukraine

Kyiv City Children's Clinical Hospital № 1, Ukraine

Nasopharyngeal pneumococcal carriage is important part of invasive infections pathogenesis and of selection of strains resistant to antibiotics.

Aim of study — to compare serotypic pneumococcal spectrum in nasopharyngeal carriage and meningitis in children up to 5 years old and study their susceptibility to antibiotics.

Materials and Methods. 900 healthy children up to 5 years old from Kiev and Kiev oblast were studied. Liquor was obtained from 89 children with pneumococcal meningitis from 7 regions of survey in Ukraine. PCR and classic bacteriologic methods were used. Study of susceptibility to 13 anti-microbial preparations was made.

Results. Among 297 pneumococcal strains isolated in nasopharyngeal carriage, 264 strains (88.9%) were capsulated and 33 (11.1 %) — uncapsulated pneumococci. 

Main serotypes were 19F (25%), 6 (16.1%), 14 (9.8%), 23F (5.3%), 18 (3.0%). Isolates of serotypes which are covered by PCV13 composed 65.5% (92.6 % in children from nurseries). Meningitis pathogens in children up to 5 years were in 93.2% the same pneumococcal serotypes as those colonizing nasopharynx of healthy children. The most often serotype was 6 (25.8%). Non typed serotypes were found in 28% cases of meningitis Serotypes 19F, 14, 23F, 18 were the cause of purulent meningitis in 5.6%, 7.9%, 11.2% and 5.6% respectively. Moderate resistence to amoxiclaves was found. In cephalosporines of 3"rd generation high antipneumococcal activity was marked.

Conclusions. Pneumococcal meningitis pathogens were in 93.2% cases the same pneumococcal serotypes as in healthy carriage. Data on pneumococcal susceptibility to antibiotics in nasopharyngeal carriage must be taken into account while choosing antibiotics for empiric therapy of pneumococcal diseases. It is worth starting giving pneumococcal conjugated vaccine to children from nursery.

Key words: pneumococci, serotypes, carriage, meningitis, children, antibiotics.

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