Colonization by Streptococcus pneumoniae in human immunodeficiency virus-infected children

Fernando P. Polack, Diane C. Flayhart, Marianna L. Zahurak, James D. Dick, Rodney E. Willoughby

Research output: Contribution to journalArticle

Abstract

Objective. Children with HIV infection are particularly susceptible to invasive pneumococcal disease, yet the effect of HIV infection and its medical management on colonization and resistance to antibiotics are poorly described. To provide a basis for medical practice, we determined the prevalence of nasopharyngeal colonization and antibiotic resistance of Streptococcus pneumoniae in children with HIV infection. Methods. Cross- sectional prevalence sample of children attending the pediatric HIV and pulmonary clinics to examine nasopharyngeal colonization with S. pneumoniae and antibiotic resistance to beta-lactams and trimethoprimsulfamethoxazole (T/S). Subjects were matched by age and date of clinic visit. Results. The colonization rate with S. pneumoniae of HIV-infected and -indeterminate children was equal to that of controls (20% vs. 19%). HIV infection, CDC staging or receipt of oral antibiotic therapy did not affect colonization. Isolates from HIV-infected and -indeterminate children were less likely to be penicillin-resistant than those from controls (18% vs. 50%). There was no difference in pneumococcal resistance to T/S among isolates from subjects and controls, despite 72% T/S use in the HIV clinic. Conclusion. Colonization with S. pneumoniae in HIV disease is no different from that of comparable children. The high incidence of pneumococcal disease and prophylaxis with T/S are not related to nasopharyngeal colonization. Antibiotic prophylaxis of HIV-infected children does not necessarily lead to increased resistance of S. pneumoniae.

Original languageEnglish (US)
Pages (from-to)608-612
Number of pages5
JournalPediatric Infectious Disease Journal
Volume19
Issue number7
DOIs
StatePublished - Jul 2000

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Streptococcus pneumoniae
HIV
HIV Infections
Microbial Drug Resistance
Antibiotic Prophylaxis
beta-Lactams
Centers for Disease Control and Prevention (U.S.)
Ambulatory Care
Penicillins
Pediatrics
Anti-Bacterial Agents
Lung
Incidence

Keywords

  • Asthma
  • Bronchopulmonary dysplasia
  • Child
  • Drug resistance
  • Human immunodeficiency virus
  • Microbial
  • Penicillin
  • Prevention and control
  • Prospective studies
  • Streptococcus pneumoniae
  • Trimethoprim-sulfamethoxazole combination

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pediatrics, Perinatology, and Child Health

Cite this

Colonization by Streptococcus pneumoniae in human immunodeficiency virus-infected children. / Polack, Fernando P.; Flayhart, Diane C.; Zahurak, Marianna L.; Dick, James D.; Willoughby, Rodney E.

In: Pediatric Infectious Disease Journal, Vol. 19, No. 7, 07.2000, p. 608-612.

Research output: Contribution to journalArticle

Polack, Fernando P. ; Flayhart, Diane C. ; Zahurak, Marianna L. ; Dick, James D. ; Willoughby, Rodney E. / Colonization by Streptococcus pneumoniae in human immunodeficiency virus-infected children. In: Pediatric Infectious Disease Journal. 2000 ; Vol. 19, No. 7. pp. 608-612.
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N2 - Objective. Children with HIV infection are particularly susceptible to invasive pneumococcal disease, yet the effect of HIV infection and its medical management on colonization and resistance to antibiotics are poorly described. To provide a basis for medical practice, we determined the prevalence of nasopharyngeal colonization and antibiotic resistance of Streptococcus pneumoniae in children with HIV infection. Methods. Cross- sectional prevalence sample of children attending the pediatric HIV and pulmonary clinics to examine nasopharyngeal colonization with S. pneumoniae and antibiotic resistance to beta-lactams and trimethoprimsulfamethoxazole (T/S). Subjects were matched by age and date of clinic visit. Results. The colonization rate with S. pneumoniae of HIV-infected and -indeterminate children was equal to that of controls (20% vs. 19%). HIV infection, CDC staging or receipt of oral antibiotic therapy did not affect colonization. Isolates from HIV-infected and -indeterminate children were less likely to be penicillin-resistant than those from controls (18% vs. 50%). There was no difference in pneumococcal resistance to T/S among isolates from subjects and controls, despite 72% T/S use in the HIV clinic. Conclusion. Colonization with S. pneumoniae in HIV disease is no different from that of comparable children. The high incidence of pneumococcal disease and prophylaxis with T/S are not related to nasopharyngeal colonization. Antibiotic prophylaxis of HIV-infected children does not necessarily lead to increased resistance of S. pneumoniae.

AB - Objective. Children with HIV infection are particularly susceptible to invasive pneumococcal disease, yet the effect of HIV infection and its medical management on colonization and resistance to antibiotics are poorly described. To provide a basis for medical practice, we determined the prevalence of nasopharyngeal colonization and antibiotic resistance of Streptococcus pneumoniae in children with HIV infection. Methods. Cross- sectional prevalence sample of children attending the pediatric HIV and pulmonary clinics to examine nasopharyngeal colonization with S. pneumoniae and antibiotic resistance to beta-lactams and trimethoprimsulfamethoxazole (T/S). Subjects were matched by age and date of clinic visit. Results. The colonization rate with S. pneumoniae of HIV-infected and -indeterminate children was equal to that of controls (20% vs. 19%). HIV infection, CDC staging or receipt of oral antibiotic therapy did not affect colonization. Isolates from HIV-infected and -indeterminate children were less likely to be penicillin-resistant than those from controls (18% vs. 50%). There was no difference in pneumococcal resistance to T/S among isolates from subjects and controls, despite 72% T/S use in the HIV clinic. Conclusion. Colonization with S. pneumoniae in HIV disease is no different from that of comparable children. The high incidence of pneumococcal disease and prophylaxis with T/S are not related to nasopharyngeal colonization. Antibiotic prophylaxis of HIV-infected children does not necessarily lead to increased resistance of S. pneumoniae.

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