Prevalence, Antimicrobial Drug Resistance and Associated Risk Factors of Streptococcus Pneumoniae Bacteria Infection Among Under-Five Children With Acute Lower Respiratory Tract Infection Attending Sheik Hassan Yebere Referral Hospital, Jig-Jiga, Ethiopia

Abstract

Background

Pneumonia is inflammation of the lung. The Streptococcus pneumoniae (S. pneumoniae) is commensal in the upper airway and can cause infection to under-five children. The bacteria is gram-positive diplococci, catalase negative, and optochin sensitive. The bacteria is the leading cause of bacterial pneumonia among under-five children. No similar data is reported from the current study area.

Objective

To determine prevalence, antimicrobial drug resistance and associated factors of S. pneumoniae infection among under-five children with acute lower respiratory tract infection attending Sheck Hassan Yebere Referral Hospital from March 1 to April 30, 2021 Jig-Jiga, Ethiopia.

Methods

A cross-sectional study was conducted among 374 study participants selected by convenience sampling method. A structured questionnaire was used to collect child data. Nasopharyngeal/oropharyngeal swabs were collected and diagnosed to isolate S. pneumoniae by using culture then identified by biochemical examination. Later antimicrobial drug resistance testing was performed by Kirby–Bauer disk diffusion method. All data were entered on epi-data 3.1 then exported to SPSS version 22 to calculate analysis. Statistically significant value was found by calculating an adjusted odds ratio with p-value ≤ 0.05 in a multivariate logistic regression model.

Results

Among 374 under-five children, 180 (48.1%) were males and 109 (29.2%) were from low income families. The overall prevalence of S. pneumoniae infection in the study was 18% (95% CI 14.4–22.2). No window (AOR=2.8 CI 1.1–7.6), no/non-exclusive breast-feeding (AOR= 2.1 CI 1.1–4.1), and previous URTI (AOR= 3.2 CI 1.7–6.1) were significantly associated with S. pneumoniae infection. The isolated organism showed drug resistance for Cotrimoxazole (35%), and Tetracycline (34%).

Conclusion

The prevalence and antimicrobial resistance in this study were comparatively high. No window, non-exclusive breast-feeding and previous URTI were associated with S. pneumoniae infection. The isolated S. pneumoniae showed high drug resistance to cotrimoxazole and tetracycline.

Keywords:

• under-five pneumonia
• antimicrobial resistance
• S. pneumoniae

Abbreviations

CLSI, Clinical Laboratory Standard Institute; LRIs, lower respiratory infections; MDR, multi-drug resistance; OPD, outpatient department; PCV, pneumococcal conjugate vaccine; URTI, upper respiratory tract infection; WAZ, weight for age Z-score; WHO, World health organization.

Data Sharing Statement

The data used in this research study is available from the corresponding author upon reasonable request.

Acknowledgment

We would like to thank Jig-Jiga University research directorate for funding us to conduct this research project. Our special thanks also to Jig-Jiga University College of Medicine and Health Science Faculty for their continuous support and tremendous follow up during the study. We would like to thank Sheck Hassan Yebere Referral Hospital Laboratory staff and pediatric nurses who participated during collection and examination of data and samples, respectively.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare that they have no competing interests.

Additional information

Funding

The funding for this research project was obtained from Jig-Jiga University Research Directorate.