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. 2020 Feb 7;15(2):e0229021.
doi: 10.1371/journal.pone.0229021. eCollection 2020.

Co-carriage of Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis among three different age categories of children in Hungary

Eszter Kovács  1 , Judit Sahin-Tóth  1 , Adrienn Tóthpál  1 , Mark van der Linden  2 , Tamás Tirczka  3 , Orsolya Dobay  1
Affiliations

Co-carriage of Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis among three different age categories of children in Hungary

Eszter Kovács et al. PLoS One. .

Abstract

Background: The nasopharynx can from time to time accommodate otherwise pathogenic bacteria. This phenomenon is called asymptomatic carriage. However, in case of decreased immunity, viral infection or any other enhancing factors, severe disease can develop. Our aim in this study was to survey the nasal carriage rates of four important respiratory pathogens in three different age groups of children attending nurseries, day-care centres and primary schools. This is the first study from Hungary about the asymptomatic carriage of H. influenzae and M. catarrhalis.

Methods: Altogether 580 asymptomatic children were screened in three Hungarian cities. Samples were collected from both nostrils with cotton swabs. The identification was based on both colony morphology and species-specific PCRs. Serotyping was performed for S. pneumoniae, H. influenzae and M. catarrhalis. Antibiotic susceptibility was determined with agar dilution, according to the EUCAST guidelines. Clonality was examined by PFGE.

Results and conclusions: Whereas the carriage rates of S. pneumoniae, H. influenzae and M. catarrhalis clearly decreased with age, that of S. aureus showed an opposite tendency. Multiple carriage was least prevalent if S. aureus was one of the participants. The negative association between this bacterium and the others was statistically significant. For pneumococcus, the overall carriage rate was lower compared to earlier years, and PCV13 serotypes were present in only 6.2% of the children. The majority of H. influenzae isolates was non-typeable and no type b was detected; serotype A was dominant among M. catarrhalis. All four bacteria were more sensitive to antibiotics compared to clinical isolates. No MRSAs were detected, but we found three mupirocin resistant strains. The positive effect of Hib- and PCV-vaccination is undoubted. Continued surveillance of these pathogens is required.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Carriage prevalence changes of the four bacterial species related to age.
Fig 2
Fig 2. Carriage rates of three bacterial species together.
Fig 3
Fig 3. Summarized serotype distribution of the pneumococci from this study (n = 210).
Red bars, PCV13 serotypes; Yellow bars, PPV23 serotypes; blue bars, NVT serotypes.
Fig 4
Fig 4. PFGE pattern of the serotype f and e H. influenzae isolates.
Fig 5
Fig 5. PFGE pattern of the three mupirocin resistant S. aureus isolates.
Fig 6
Fig 6. PFGE dendrogram of the serotype 11A pneumococcal isolates from this study.
See this image and copyright information in PMC

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