Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector3343310.17816/KMJ2020-330Research ArticlePhage sensitivity profiles of a nasopharyngeal opportunistic pathogen in Streptococcus pneumoniae carrier children with recurrent respiratory infectionsBayazitovaL Tbajalt@mail.ruTupkinaO Fbajalt@mail.ruChazovaT Abajalt@mail.ruKonyshevN Sbajalt@mail.ruSyuzevK Nbajalt@mail.ruIsaevaG Shbajalt@mail.ruKazan Scientific and Research Institute of Epidemiology and MicrobiologyKazan State Medical University1306202010133303361404202013052020Copyright © 2020, Bayazitova L.T., Tupkina O.F., Chazova T.A., Konyshev N.S., Syuzev K.N., Isaeva G.S.2020<p><strong>Aim.</strong> To study the nature of microbiota and estimating the susceptibility to antibiotics and bacteriophages of conditionally pathogenic microflora of the nasopharynx in children-pneumococcal carriers with recurrent respiratory infections.</p>
<p><strong>Methods.</strong> Researching microflora was conducted in 182 pneumococcal carriers receiving help in Kazan Scientific and Research Institute of Epidemiology and Microbiology. Microbial identification, testing of susceptibility to antibiotics and bacteriophages was carried out following the regulatory documentation. Bacterial isolates were confirmed by mass spectrometry. The phage titer was determined by the method of agar layers according to Grazia.</p>
<p><strong>Results.</strong> Nasopharyngeal S. pneumoniae species was presented by Staphylococcus spp., Moraxella spp., Haemophilus spp., Corynebacterium spp., Klebsiella spp and Candida spp. The antimicrobial resistance profiles of Streptococcus pneumoniae: resistant to oxacillin was detected in 20.7% of strains, to erythromycin in 45.9%, to clindamycin in 20%, to trimethoprim-sulfamethoxazole in 18.4%. 19.6% of isolates were multidrug-resistant (MDR, resistant to 3 or more antimicrobial agents). Phage susceptibility test of S. pneumoniaе showed that 97.2% of isolates were resistant to streptococcal bacteriophage, 75% to pyobacteriophage. All antibiotic-resistant strains remained susceptible to Streptococcus phages. The phage titer of Klebsiella in agreement with Grazia method of Kl. pneumoniae ranged from 9106 to 5105 PFU/mL. The ranking results of activities of antistaphylococcal antibiotics (effectiveness descending): fusidic acid mupirocin chloramphenicol cyprofloxacin erythromycin.</p>
<p><strong>Conclusion.</strong> Nasopharyngeal microbiota of pneumococci carriers children is represented by a variable polymicrobial association; nasopharyngeal strains are effectively lysed by bacteriophages; mono- and polyvalent bacteriophages can be used as an alternative to antibacterial treatment in Streptococcus pneumoniae carriers children with recurrent respiratory infections.</p>nasopharynx microbiocenosispneumococcal carriagerecurrent respiratory infectionsantibiotic resistancebacteriophagesмикробиоценозпневмококковое носительстворекуррентные респираторные инфекцииантибиотикорезистентностьбактериофаги[García-Rodríguez J.A., Fresnadillo Martínez M.J. Dynamics of nasopharyngeal colonization by potential respiratory pathogens. J. Antimicrob. Chemother. 2002; 50 (suppl. S2): 59–73. DOI: 10.1093/jac/dkf506.][Pericone C.D., Overweg K., Hermans P.W.M., Jeffrey N. Weiser inhibitory and bactericidal effects of hydrogen peroxide production by Streptococcus pneumoniae on other inhabitants of the upper respiratory tract. Infection and Immunity. 2000; 68 (7) 3990–3997. DOI: 10.1128/IAI.68.7.3990-3997.2000.][Dunne E.M., Murad C., Sudigdoadi S. et al. Carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Indonesian children: A cross-sectional study. PLoS One. 2018; 13 (4): e0195098. DOI: 10.1371/journal.pone.0195098.][Andrade D.C., Borges I.C., Bouzas M.L. et al. Antibody responses against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in children with acute respiratory infection with or without nasopharyngeal bacterial carriage. Infect. Dis. (Lond.). 2018; 50 (9): 705–713. DOI: 10.1080/23744235.2018.1463451.][Camelo-Castillo A., Henares D., Brotons P. et al. Nasopharyngeal microbiota in children with invasive pneumococcal disease: Identification of bacteria with potential disease-promoting and protective effects. Front. Microbiol. 2019; 10: 11. DOI: 10.3389/fmicb.2019.00011.][Dunne E.M., Smith-Vaughan H.C., Robins-Browne R.M. et al. Nasopharyngeal microbial interactions in the era of pneumococcal conjugate vaccination. Vaccine. 2013; 31 (19): 2333–2342. DOI: 10.1016/j.vaccine.2013.03.024.][Valiyeva R.I., Bayazitova L.T., Tyupkina O.F. et al. Nasopharynx microbiota at children carriers of S. pneumoniae with frequent respiratory infections. In «Nauchnoe obespechenie protivoepidemicheskoy zashchity naseleniya: aktual'nye problemy i resheniya» Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem, posvyashchennoy 100-letiyu FBUN NNIIEM im. akademika I.N. Blokhinoy Rospotrebnadzora (11–12 sentyabrya 2019, Nizhniy Novgorod). 2019; 257–259. (In Russ.)][Cherazard R., Epstein M., Doan T.L. et al. Antimicrobial resistant Streptococcus pneumoniae: Prevalence, mechanisms, and clinical implications. Am. J. Therap. 2017; 24: 361–369. DOI: 10.1097/MJT.0000000000000551.][Hackel M., Lascols C., Bouchillon S. et al. Serotype prevalence and antibiotic resistance in Streptococcus pneumoniae clinical isolates among global populations. Vaccine. 2013; 31: 4881–4887. DOI: 10.1016/j.vaccine.2013.07.054.][Bayazitova L.T., Tyupkina O.F., Chazova T.A. et al. Community-acquired pneumonia pneumococcal etiology and microbiological aspects of nasopharyngeal carriage in children in the Republic of Tatarstan. Russian journal of infection and immunity. 2017; 7 (3): 271–278. (In Russ.) DOI: 10.15789/2220-7619-2017-3-271-278.][MP 4.2.0114-16. Laboratornaya diagnostika vnebol'nichnoy pnevmonii pnevmokokkovoy etiologii. (Laboratory diagnosis of community-acquired pneumonia.) M. 2017. https://files.stroyinf.ru/Data2/1/4293743/4293743035.htm (access date: 02.04.2020). (In Russ.)]