Serotype distribution and antibiotic susceptibility of invasive and nasopharyngeal isolates of Streptococcus pneumoniae among children in rural Mozambique

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Abstract
Objective To describe and compare serotype distribution and antibiotic susceptibility of invasive and nasopharyngeal isolates of Streptococcus pneumoniae from children in rural Mozambique. Methods From August 2002 to July 2003, we prospectively obtained invasive pneumococcal isolates from children vs. 20%, P < 0.01), to have intermediate-level penicillin resistance (52%vs. 14%, P < 0.01) and to be non-susceptible to trimethoprim–sulfamethoxazole (61%vs. 45%, P < 0.01). Recent receipt of antibiotics or sulfadoxine/pyrimethamine were associated with carriage of antibiotic non-susceptible isolates. Conclusions These data indicate that a pneumococcal conjugate vaccine containing serotypes 1 and 5 could substantially reduce pneumococcal invasive disease among young children in rural Mozambique. Carriage surveys can overestimate potential coverage of the seven-valent pneumococcal conjugate vaccine in settings where serotypes 1 and 5 predominate.