Nasopharyngeal Colonization and levofloxacin Susceptibility of Streptococcus pneumoniae among Healthcare Workers in a Teaching Hospital in Tehran, Iran
Novelty in Biomedicine,
Vol. 8 No. 3 (2020),
13 July 2020
AbstractBackground: Streptococcus pneumoniae commonly asymptomatically colonizes the human upper respiratory tract and the carriage rate varies between geographical regions. The colonized individuals are not only at risk of infections but also can be a source of transmission of the pathogen. The risk of the droplet or airborne transmission of pneumococcal strains healthcare workers is considerable. The current study aimed to determine the extent of nasopharyngeal colonization with S. pneumoniae and their levofloxacin susceptibility at a tertiary hospital in Tehran, Iran.
Materials and Methods: During a six-month period, the nasopharyngeal swab samples collected from 300 volunteer healthcare workers of Imam Hossein Hospital. Samples screened for S. pneumoniae using standard conventional biochemical methods. The minimum inhibitory concentration (MIC) of levofloxacin was determined using a commercially available strip antibiotic test according to the clinical laboratory standards institute (CLSI) guidelines.
Results: A total of 19 (6.3%) enrolled healthcare workers were colonized with S. pneumoniae. Amongst the enrolled volunteers, nurses had a higher rate of pneumococcal colonization (47.3%) followed by interns (21%) and laboratory workers (15.8%). Our analysis revealed that there was a significant correlation between smoking and pneumococcal colonization. The antimicrobial susceptibility testing showed that all of the isolates were susceptible to levofloxacin (MIC≤2 μg/ml).
Conclusion: This low rate of pneumococcal colonization amongst healthcare professionals may be attributed to the low risk of horizontal transmission of severe pneumococcal infections in the hospital. Additionally, our findings indicated that levofloxacin was an effective antimicrobial agent for the treatment of pneumococcal infections.
- S. pneumoniae, Health care workers, Nasopharyngeal carriage, Colonization, Levofloxacin
How to Cite
Weiser JN, Ferreira DM, Paton JC. Streptococcus pneumoniae: transmission, colonization and invasion. Nat Rev Microbiol. 2018;16(6):355-67.
Koedel U, Scheld WM, Pfister HW. Pathogenesis and pathophysiology of pneumococcal meningitis. The Lancet infectious diseases. 2002: 2(12):721-36.
Houri H, Pormohammad A, Riahi SM, Nasiri MJ, Fallah F, Dabiri H, et al. Acute bacterial meningitis in Iran: Systematic review and meta-analysis. PLOS ONE. 2017;12(2):e0169617.
Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375(9730):1969-87.
Ludwig E, Bonanni P, Rohde G, Sayiner A, Torres A. The remaining challenges of pneumococcal disease in adults. 2012; 21(123):57-65.
Wada FW, Tufa EG, Berheto TM, Solomon FB. Nasopharyngeal carriage of Streptococcus pneumoniae and antimicrobial susceptibility pattern among school children in South Ethiopia: post-vaccination era. BMC Research Notes. 2019;12(1):306.
Dube FS, Ramjith J, Gardner-Lubbe S, Nduru P, Robberts FJL, Wolter N, et al. Longitudinal characterization of nasopharyngeal colonization with Streptococcus pneumoniae in a South African birth cohort post 13-valent pneumococcal conjugate vaccine implementation. Scientific Reports. 2018;8(1):12497.
Yu Y-Y, Xie X-H, Ren L, Deng Y, Gao Y, Zhang Y, et al. Epidemiological characteristics of nasopharyngeal Streptococcus pneumoniae strains among children with pneumonia in Chongqing, China. Scientific reports. 2019;9(1):3324-4.
Blasi F, Mantero M, Santus P, Tarsia P. Understanding the burden of pneumococcal disease in adults. Clinical Microbiology and Infection. 2012;18:7-14.
Donkor ES. Understanding the pneumococcus: transmission and evolution. Front Cell Infect Microbiol. 2013;3:7-7.
Houri H, Kazemian H, Sedigh Ebrahim-Saraie H, Taji A, Tayebi Z, Heidari H. Linezolid activity against clinical Gram-positive cocci with advanced antimicrobial drug resistance in Iran. Journal of Global Antimicrobial Resistance. 2017;10:200-3.
Houri H, Tabatabaei SR, Saee Y, Fallah F, Rahbar M, Karimi A. Distribution of capsular types and drug resistance patterns of invasive pediatric Streptococcus pneumoniae isolates in Teheran, Iran. International Journal of Infectious Diseases. 2017;57:21-6.
Rafiei Tabatabaei S, Rahbar M, Nazari Alam A, Fallah F, Hashemi A, Yousefi M, et al. Detection of pbp2b Gene and Antimicrobial Susceptibility Pattern of Streptococcus Pneumoniae Isolates in Tehran Hospitals, Iran. 2017;5(1):e38891.
Werno AM, Murdoch DR. Medical microbiology: laboratory diagnosis of invasive pneumococcal disease. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2008;46(6):926-32.
Nunes MC, Shiri T, van Niekerk N, Cutland CL, Groome MJ, Koen A, et al. Acquisition of Streptococcus pneumoniae in pneumococcal conjugate vaccine-naive South African children and their mothers. The Pediatric Infectious Disease Journal. 2013;32(5):e192-205.
Ramos-Sevillano E, Moscoso M, García P, García E, Yuste J. Nasopharyngeal Colonization and Invasive Disease Are Enhanced by the Cell Wall Hydrolases LytB and LytC of Streptococcus pneumoniae. PLOS ONE. 2011;6(8):e23626.
Koliou MG, Andreou K, Lamnisos D, Lavranos G, Iakovides P, Economou C, et al. Risk factors for carriage of Streptococcus pneumoniae in children. BMC Pediatr. 2018;18(1):144.
Zivich PN, Grabenstein JD, Becker-Dreps SI, Weber DJ. Streptococcus pneumoniae outbreaks and implications for transmission and control: a systematic review. Pneumonia (Nathan). 2018;10:11.
Guggenbichler JP, Assadian O, Boeswald M, Kramer A. Incidence and clinical implication of nosocomial infections associated with implantable biomaterials - catheters, ventilator-associated pneumonia, urinary tract infections. GMS Krankenhhyg Interdiszip. 2011;6(1):Doc18.
Stupka JE, Mortensen EM, Anzueto A, Restrepo MI. Community-acquired pneumonia in elderly patients. Aging health. 2009;5(6):763-74.
Bhatta DR, Hamal D, Shrestha R, Parajuli R, Baral N, Subramanya SH, et al. Nasal and Pharyngeal Colonization by Bacterial Pathogens: A Comparative Study between Preclinical and Clinical Sciences Medical Students %J Canadian Journal of Infectious Diseases and Medical Microbiology. 2018;2018:6.
Hosuru Subramanya S, Thapa S, Dwedi SK, Gokhale S, Sathian B, Nayak N, et al. Streptococcus pneumoniae and Haemophilus species colonization in health care workers: the launch of invasive infections? BMC Research Notes. 2016; 9:66.
Mackenzie GA, Leach AJ, Carapetis JR, Fisher J, Morris PS. Epidemiology of nasopharyngeal carriage of respiratory bacterial pathogens in children and adults: cross-sectional surveys in a population with high rates of pneumococcal disease. BMC Infectious Diseases. 2010;10(1):304.
Mousavi SF, Nobari S, Rahmati Ghezelgeh F, Lyriai H, Jalali P, Shahcheraghi F, et al. Serotyping of Streptococcus pneumoniae isolated from Tehran by Multiplex PCR: Are serotypes of clinical and carrier isolates identical? Iran J Microbiol. 2013;5(3):220-6.
Sanaei Dashti A, Abdinia B, Karimi A. Nasopharyngeal carrier rate of Streptococcus pneumoniae in children: serotype distribution and antimicrobial resistance. Archives of Iranian medicine. 2012;15(8):500-3.
Hammitt LL, Bruden DL, Butler JC, Baggett HC, Hurlburt DA, Reasonover A, et al. Indirect effect of conjugate vaccine on adult carriage of Streptococcus pneumoniae: an explanation of trends in invasive pneumococcal disease. The Journal of Infectious Diseases. 2006;193(11):1487-94.
Adler H, Nikolaou E, Gould K, Hinds J, Collins AM, Connor V, et al. Pneumococcal Colonization in Healthy Adult Research Participants in the Conjugate Vaccine Era, United Kingdom, 2010–2017. The Journal of Infectious Diseases. 2019;219(12):1989-93.
Dhakal R, Sujatha S, Parija SC, Bhat BV. Asymptomatic colonization of upper respiratory tract by potential bacterial pathogens. Indian Journal of pediatrics 2010; 77(7):775-778.
Murphy TF. Otitis media, bacterial colonization, and the smoking parent. Clinical infectious Diseases: an official publication of the Infectious Diseases Society of America. 2006;42(7):904-6.
Vasoo S, Singh K, Hsu LY, Chiew YF, Chow C, Lin RT, et al. Increasing antibiotic resistance in Streptococcus pneumoniae colonizing children attending day-care centres in Singapore. Respirology (Carlton, Vic). 2011;16(8):1241-8.
Peterson J, Yektashenas B, Fisher AC. Levofloxacin for the treatment of pneumonia caused by Streptococcus pneumoniae including multidrug-resistant strains: pooled analysis. Current Medical Research and Opinion. 2009;25(3):559-68.
Sallam M, Abbadi J, Natsheh A, Ababneh NA, Mahafzah A, Özkaya Şahin G. Trends in Antimicrobial Drug Resistance of Streptococcus pneumoniae Isolates at Jordan University Hospital (2000⁻2018). Antibiotics (Basel). 2019;8(2):41.
Kim SH, Song JH, Chung DR, Thamlikitkul V, Yang Y, Wang H, et al. Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrobial agents and chemotherapy. 2012;56(3):1418-26.
- Abstract Viewed: 65 times
- PDF Downloaded: 44 times