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Clinical Trial
. 2025 May 1;44(5):387-393.
doi: 10.1097/INF.0000000000004744. Epub 2025 Feb 3.

Nasopharyngeal Carriage and Antibiotic Resistance in Children With Sickle Cell Disease: The DREPANOBACT French Multicenter Prospective Study

Luu-Ly Pham  1   2 , Emmanuelle Varon  3   4 , Stéphane Bonacorsi  2   4   5 , Marouane Boubaya  6 , Patricia Benhaim  7 , Lahoueri Amor-Chelihi  7 , Marine Houlier  7 , Bérengère Koehl  8 , Florence Missud  8 , Valentine Brousse  8 , Vincent Gajdos  9 , Etienne Bizot  9 , Coralie Briand  1 , Alexandra Malka  1 , Marie-Hélène Odièvre  10 , Anne-Sophie Romain  10 , Isabelle Hau  11 , Corinne Pondarré  11   12 , Hélène See  7 , Corinne Guitton  13 , Férielle Zenkhri  13 , Laurent Holvoet  8 , Malika Benkerrou  8 , Charlène Da Silveira  1 , Nabil Belaid  14 , Odile Laurent  7 , Mélanie Vassal  11 , Romain Basmaci  7 , Camille Aupiais  1 , Coralie Bloch-Queyrat  6 , Corinne Lévy  4 , Robert Cohen  4 , Naïm Ouldali  2   15 , Loïc De Pontual  1 , Etienne Carbonnelle  2   16 , Jean Gaschignard  2   17
Affiliations
Clinical Trial

Nasopharyngeal Carriage and Antibiotic Resistance in Children With Sickle Cell Disease: The DREPANOBACT French Multicenter Prospective Study

Luu-Ly Pham et al. Pediatr Infect Dis J. .

Abstract

Background: Children with sickle cell disease (SCD) are susceptible to invasive bacterial infections, particularly those caused by Streptococcus pneumoniae . Data concerning nasopharyngeal carriage remain scarce in this population at high risk of resistant bacteria owing to antibiotic pressure and frequent hospitalizations.

Methods: We conducted this prospective trial, DREPANOBACT, in 7 French hospitals to assess the nasopharyngeal carriage rate for S. pneumoniae among children with SCD aged 6 months-15 years between September 2022 and April 2024. The secondary aim was to determine the serotype distribution and proportion of penicillin nonsusceptible S. pneumoniae isolates and the carriage and antibiotic resistance rates for Staphylococcus aureus, Moraxella catarrhalis and Haemophilus influenzae.

Results: In total, 300 children were enrolled [median age, 8 years (interquartile range: 4-12 years)]. S. pneumoniae carriage accounted for 32 cases (11%), including 21 penicillin nonsusceptible S. pneumoniae strains (66%). The main serotypes were 23A (n = 4), 35B (n = 4), 11A (n = 3) and 15C (n = 3). Overall, 75% of the serotypes were non-13-valent pneumococcal conjugate vaccine (PCV) serotypes, with 19% and 53% covered by PCV20 and PCV21, respectively. The carriage rates for S. aureus, M. catarrhalis and H. influenzae were 31%, 17% and 11%, respectively. Methicillin resistance was observed in 5% of S. aureus strains. Age ≤5 years was significantly associated with S. pneumoniae, M. catarrhalis , and H. influenzae carriage, while age ≥11 years was associated with S. aureus carriage.

Conclusions: Surveillance of nasopharyngeal carriage in children with SCD is warranted to monitor changes in predominant serotypes and resistance patterns.

Trial registration: ClinicalTrials.gov NCT05197205.

Keywords: antibiotic resistance; nasopharyngeal carriage; sickle cell disease.

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Conflict of interest statement

C.L. reports grants to the institution ACTIV from GSK, Sanofi, Pfizer and Merck and personal fees and nonfinancial support from Pfizer and Merck outside the conduct of the study. R.C. reports grants to the institution ACTIV, personal fees and nonfinancial support from GSK, Sanofi, Pfizer and Merck outside the submitted work. The other authors have no conflicts of interest.

References

    1. Piel FB, Steinberg MH, Rees DC. Sickle cell disease. N Engl J Med. 2017;376:1561–1573.
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    1. Gaschignard J, Koehl B, Rees DC, et al.; BACT-SPRING study group. Invasive bacterial infections in children with sickle cell disease: 2014-2019. Pediatrics. 2023;152:e2022061061.
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    1. Oligbu G, Collins S, Sheppard C, et al. Risk of invasive pneumococcal disease in children with sickle cell disease in England: a national observational cohort study, 2010-2015. Arch Dis Child. 2018;103:643–647.

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