Nasopharyngeal Carriage of <i>Streptococcus pneumoniae</i> in Tunisian Healthy under-Five Children during a Three-Year Survey Period (2020 to 2022)
Nourelhouda Ben Ayed,
Sonia Ktari,
Jihen Jdidi,
Omar Gargouri,
Fahmi Smaoui,
Haifa Hachicha,
Boutheina Ksibi,
Sonda Mezghani,
Basma Mnif,
Faouzia Mahjoubi,
Adnene Hammami
Affiliations
Nourelhouda Ben Ayed
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Sonia Ktari
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Jihen Jdidi
Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia
Omar Gargouri
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Fahmi Smaoui
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Haifa Hachicha
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Boutheina Ksibi
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Sonda Mezghani
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Basma Mnif
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Faouzia Mahjoubi
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
Adnene Hammami
Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia
We aimed to assess the prevalence of nasopharyngeal pneumococcal carriage and to determine serotype distribution, antibiotic susceptibility patterns, and evolutionary dynamics of Streptococcus pneumoniae isolates in healthy under-five children. Nasopharyngeal swabs were collected from healthy children over three survey periods between 2020 and 2022. All pneumococcal isolates were serotyped and tested for antimicrobial susceptibility. A total of 309 S. pneumoniae isolates were collected, with an overall prevalence of nasopharyngeal pneumococcal carriage of 24.4% (CI95%: [22–26.8%]). These isolates were classified into 25 different serotypes. The most common serotypes were 14 (14.9%), 19F (12%), 6B (10.4%), and 23F (7.4%), which are covered by the PCV10 vaccine, as well as 19A (8.4%) and 6A (7.8%), which are covered by the PCV13 vaccine. A significant decrease in the proportion of serotype 19F (p = 0.001) and an increase in serotypes 19A (p = 0.034) and 6A (p = 0.029) were observed between the three survey periods. Multidrug resistance (MDR) was noted for 56.6% of the isolates. A significant association with antimicrobial resistance was observed for the most frequent serotypes, mainly serotype 19A. In conclusion, one-quarter of healthy under-five children in Tunisia carried S. pneumoniae in their nasopharynx. A dominance of vaccine serotypes significantly associated with antimicrobial resistance was recorded.
