Bikas K Arya1, Sangeeta Das Bhattacharya2, Gautam Harigovind1, Ranjan S Das1, Tila Khan1, Feroze Ganaie3, Swapan K Niyogi4, K L Ravikumar3, Anand Manoharan5,6, Subhasish Bhattacharyya7,8, Samiran Panda4,9, Sutapa Mandal4, Banuja Acharya1. 1. School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India. 2. School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India. sangeeta@smst.iitkgp.ernet.in. 3. Department of Microbiology, Kempegowda Institute of Medical Sciences, KR Road, VV Puram, Bengaluru, Karnataka, India. 4. National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR), P- C.I.T. Scheme XM, Beleghata, 33, CIT Rd, Subhas Sarobar Park, Phool Bagan, Beleghata, Kolkata, West Bengal, India. 5. Medicine Unit I & ID, Christian Medical College & Hospital, Vellore, Ida Scudder Road, Vellore, Tamil Nadu, India. 6. CHILDS Trust Medical Research Foundation, Chennai, India. 7. Department of Pediatrics, Midnapore Medical College and Hospital, Vidyasagar Road, Paschim Medinipur, Medinipur, West Bengal, India. 8. Department of Pediatrics College of Medicine and Sagore Dutta Hospital, Kamarhati, Kolkata, India. 9. National AIDS Research Institute Pune (NARI/ICMR), Plot No 73, G-block, M I D C, Bhosari, Pune, Maharashtra, India.
Abstract
OBJECTIVES: To investigate the difference in pneumococcal carriage, acquisition, antibiotic resistance profiles and serotype distribution, in human immunodeficiency virus (HIV) affected and unaffected families. METHODS: A prospective cohort study was conducted in children with and without HIV in West Bengal from March 2012 through August 2014, prior to 13-valent pneumococcal conjugate vaccine (PCV-13) immunization. One thousand four hundred forty one nasopharyngeal swabs were collected and cultured at five-time points from children and their parents for pneumococcal culture, and serotyping by Quellung method. RESULTS: One hundred twenty five HIV infected children and their parents, and 47 HIV uninfected children and their parents participated. Two hundred forty pneumococcal isolates were found. In children under 6 y, the point prevalence of colonization was 31% in children living with HIV (CLH) and 32% in HIV uninfected children (HUC), p = 0.6. The most common vaccine type (VT) serotypes were 6A, 6B and 19A. All isolates from parents and 71% from children in the HIV uninfected cohort were PCV-13 representative, compared to 33% of isolates from CLH and their parents. Acquisition rate in children was 1.77 times that of parents (OR = 1.77, 95%CI: 1.18-2.65). The HIV status of child or parent did not affect acquisition. Isolates from CLH were more frequently resistant to multiple antibiotics (p = 0.02). CONCLUSIONS: While the rate of pneumococcal carriage and acquisition did not differ between CLH and HUC, HIV affected families had exposure to a wider range of serotypes including non-vaccine type serotypes and antibiotic resistant serotypes, than HIV unaffected families.
OBJECTIVES: To investigate the difference in pneumococcal carriage, acquisition, antibiotic resistance profiles and serotype distribution, in human immunodeficiency virus (HIV) affected and unaffected families. METHODS: A prospective cohort study was conducted in children with and without HIV in West Bengal from March 2012 through August 2014, prior to 13-valent pneumococcal conjugate vaccine (PCV-13) immunization. One thousand four hundred forty one nasopharyngeal swabs were collected and cultured at five-time points from children and their parents for pneumococcal culture, and serotyping by Quellung method. RESULTS: One hundred twenty five HIV infectedchildren and their parents, and 47 HIV uninfected children and their parents participated. Two hundred forty pneumococcal isolates were found. In children under 6 y, the point prevalence of colonization was 31% in children living with HIV (CLH) and 32% in HIV uninfected children (HUC), p = 0.6. The most common vaccine type (VT) serotypes were 6A, 6B and 19A. All isolates from parents and 71% from children in the HIV uninfected cohort were PCV-13 representative, compared to 33% of isolates from CLH and their parents. Acquisition rate in children was 1.77 times that of parents (OR = 1.77, 95%CI: 1.18-2.65). The HIV status of child or parent did not affect acquisition. Isolates from CLH were more frequently resistant to multiple antibiotics (p = 0.02). CONCLUSIONS: While the rate of pneumococcal carriage and acquisition did not differ between CLH and HUC, HIV affected families had exposure to a wider range of serotypes including non-vaccine type serotypes and antibiotic resistant serotypes, than HIV unaffected families.
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