The Indian Journal of Pediatrics

, Volume 78, Issue 4, pp 423–429 | Cite as

High Rates of Colonization with Drug Resistant Hemophilus Influenzae Type B and Streptococccus Pneumoniae in Unvaccinated HIV Infected Children from West Bengal

  • Sangeeta Das Bhattacharya
  • Swapan Kumar Niyogi
  • Subhasish Bhattacharyya
  • Sean Fitzwater
  • Nageshwar Chauhan
  • A. Sudar
  • Sutapa Mandal
Original Article



To determine nasopharyngeal colonization rates of two vaccine preventable bacterial pathogens Hemophilus influenzae type b (Hib), and Streptococcus pneumoniae (Pneumococcus), antibiotic susceptibility of isolates, factors associated with their colonization, and immunization history in a cohort of HIV infected children.


The authors conducted a cross-sectional nasopharyngeal swab survey of 151 children affected with HIV presenting for routine outpatient care in West Bengal, India.


151 HIV affected children were enrolled. The median age was 6, 148/151 children were HIV positive, 65% had moderate to severe malnutrition, 53% were moderately to severely immunosuppressed, 17% were on antiretroviral therapy (ART), 90% were on cotrimoxazole prophylaxis (TMP/SMX). None had received the pneumococcal or Hib conjugate vaccines. Hib prevalence was 13% and pneumococcal prevalence was 28%. Children with normal or moderate immune suppression had high rates of colonization compared to those with severe immunosuppression (71% Hib, 61% pneumococcus). Hib and pneumococcal isolates had high rates of resistance to tested antibiotics including TMP/SMX and third generation cephalosporins. Neither ART nor TMP/SMX prevented colonization. Children colonized with multidrug resistant isolates had high rates of exposure to TMP/SMX.


HIV infection, late access to ART, high rates of colonization to resistant organisms and lack of access to vaccines makes this population vulnerable to invasive disease from Hib and pneumococcus.


Hemophilus influenzae type b Streptococcus pneumonia Pediatric HIV Hib Conjugate vaccines Hib conjugate vaccine Pneumococcal conjugate vaccine 



We would like to acknowledge Mr. Ashish Paul for assistance in data collection and Dr. Mathuram Santosham for reviewing an earlier version of this manuscript.

Conflict of Interest


Role of Funding Source

This work was funded by an Institutional grant from IIT-Kgp.


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Copyright information

© Dr. K C Chaudhuri Foundation 2010

Authors and Affiliations

  • Sangeeta Das Bhattacharya
    • 1
  • Swapan Kumar Niyogi
    • 2
  • Subhasish Bhattacharyya
    • 3
  • Sean Fitzwater
    • 4
  • Nageshwar Chauhan
    • 1
  • A. Sudar
    • 1
  • Sutapa Mandal
    • 2
  1. 1.School of Medical Science and TechnologyIndian Institute of Technology KharagpurKharagpurWest BengalIndia
  2. 2.Division of BacteriologyNational Institute of Cholera and Enteric DiseasesKolkataIndia
  3. 3.Department of PediatricsMedical College KolkataKolkataIndia
  4. 4.Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimore MDUSA

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