ABSTRACT
A serial multiplex PCR approach was reformulated for pneumococcal serotyping to test 153 clinical isolates from children in Mozambique. This approach identified serotypes in 139 (90.8%) of 153 isolates; 126 (82.4%) were identified within two reactions. This approach in developing countries would require minimal training and could provide useful serotype information without requiring transport of specimens.
Subject(s)
Antigens, Bacterial/genetics , Bacterial Typing Techniques/methods , Pneumococcal Infections/microbiology , Polymerase Chain Reaction/methods , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/genetics , Adolescent , Bacterial Capsules/genetics , Child , Child, Preschool , Genotype , Humans , Infant , Mozambique/epidemiology , Pneumococcal Infections/epidemiology , Serotyping/methods , Streptococcus pneumoniae/isolation & purificationABSTRACT
OBJECTIVE: To describe and compare serotype distribution and antibiotic susceptibility of invasive and nasopharyngeal isolates of Streptococcus pneumoniae from children in rural Mozambique. METHODS: From August 2002 to July 2003, we prospectively obtained invasive pneumococcal isolates from children <15 years of age admitted to the paediatric ward of Manhiça District Hospital. During a cross-sectional study of children <5 years of age with mild illnesses, attending the outpatient department of the hospital in March and April 2003, we collected nasopharyngeal isolates. Serotypes and antibiotic susceptibilities were determined using standardized methods. RESULTS: The two most common pneumococcal serotypes among invasive isolates were types 1 (40% of 88 isolates serotyped) and 5 (10%), but these types were rare among nasopharyngeal isolates. Compared with invasive isolates, nasopharyngeal isolates were more likely to be serotypes in the licensed seven-valent conjugate vaccine (49%vs. 20%, P < 0.01), to have intermediate-level penicillin resistance (52%vs. 14%, P < 0.01) and to be non-susceptible to trimethoprim-sulfamethoxazole (61%vs. 45%, P < 0.01). Recent receipt of antibiotics or sulfadoxine/pyrimethamine were associated with carriage of antibiotic non-susceptible isolates. CONCLUSIONS: These data indicate that a pneumococcal conjugate vaccine containing serotypes 1 and 5 could substantially reduce pneumococcal invasive disease among young children in rural Mozambique. Carriage surveys can overestimate potential coverage of the seven-valent pneumococcal conjugate vaccine in settings where serotypes 1 and 5 predominate.
