+44 1400 530055Pneumonia and lower respiratory infections among under-5 hospitalized children in malaysia: Insights on nasopharyngeal staphylococcus aureus yielding phenotypic and genotypic variations between oxacillin/methicillin sensitive (MSSA) and resistant (MRSA)-strains
10th American Pediatrics healthcare & Pediatric Infectious Diseases Congress
September 20-22, 2017 | Toronto, Canada
Kazi Selim Anwar, Tetsuya Matsumoto, Rayhan Ahmed and Anwar Hossain
AIMST University, Malaysia Tokyo Medical University, Japan
Posters & Accepted Abstracts : Pediatric Healthcare & Pediatric Infections
Abstract:
Background: Staphylococcus aureus, particularly the MRSA strains (resistant to oxacillin/methicillin and other antimicrobials) causes infections commonly including pneumonia accounting for 3-5%, globally, Since childhoodpneumonia in Malaysia ranges between 7-44% but, molecular epidemiology of naso-pharyngeal S. aureus has been scarcely reported, we conducted this cross-sectional study. Objective(s): To determine prevalence of staphylococcal pneumonia among under-5 years-old and to compare phenotypic and genotypic diversities between oxacillin/ methicillin sensitive (MSSA) and resistant (MRSA) S. aureusstrains. Methodology: With mother’s consent, nasopharyngealswabs (NPS) were collected from randomly selected 220 hospital admitted children in two tertiary-care hospitals in Kedah, Malaysia. Bacterial isolates grown on mannitolsalt and blood-agar plates were incubated (+35o-37oC), overnight. Colony morphology read, gram-stained done and bio-chemical tests (+ve catalase & coagulase & CHOfermented) performed. Antimicrobial-resistance using 8 antibiotic-disks: AMC20, CRO30, CIP5, E15, CN10, S10, TE30, VA30; OX1) were performed. For genetic-analysis PCR (Sigma, USA) were performed employing rapid DNA isolation and thermal cycler (Bio-Rad, USA) using two specific-primers femA (confirming MSSA) and mecA (confirming MRSA) by tracing electrophoretic-DNA band-size on agarose-gel. Results: Of all suspected cases, 76% were clinically diagnosed as pneumonia. NPS from 32.6% yielded MSSA among which 39.4% were MRSA when identified phenotypically. Lower MRSA-prevalence was observed genotypically (32%) than phenotypically (39%). While no differences existed between MRSA & MSSA phenotypically, genetically it did significantly (p<0.01), particularly for pneumonic cases (p<0.04) showing marked difference in carrying femA and mecA genes (p<0.00). Conclusion and Recommendation: Although MSSA, other than MRSA is associated to cause childhood-pneumonia, detailed molecular-epidemiology is recommended to elucidate genetic diversities of S. aureus implicating childhood pneumonia.
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