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Tsirigotaki M, Galanakis E. Impact of vaccines on Staphylococcus aureus colonization: A systematic review and meta-analysis. Vaccine 2023; 41:6478-6487. [PMID: 37777451 DOI: 10.1016/j.vaccine.2023.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/17/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Concerns regarding vaccine effects on microbial ecology have led to interest in the non-targeted effects of vaccinations. OBJECTIVES To systematically review the literature related to the impact of vaccines on S. aureus carriage. METHODS We conducted a systematic search of MEDLINE, Scopus and clinical trials.gov for studies that assessed vaccine effects on S. aureus carriage in children and adults using predefined inclusion and exclusion criteria. Generic inverse variance meta-analysis was done using random-effects models. RESULTS Of 1,686 studies screened, 34 were eligible for inclusion, of which 22 were observational and 12 randomized controlled studies (RCTs). 88.2% (30/34) provided data on pneumococcal conjugate vaccines (PCV), 23.5% on influenza vaccines (8/34), 6% on other vaccines (2/34) and 20.6% on more than one vaccine (7/34). Most studies tested nasopharyngeal specimens (82.3%, 28/34). Among children aged more than 18-24 months, evidence suggested no effect of PCV on S. aureus colonization [2 RCTs, pooled OR 1.09 (95% CI 0.94-1.25), p 0.25; 7 observational studies, pooled OR: 1.02 (95% CI 0.83-1.25), p 0.86]. A transient increase in S. aureus carriage in PCV-vaccinated infants 9-15 months was shown [2 RCTs, pooled OR 1.11 (95% CI 1.00-1.23), p 0.06; 4 observational studies, pooled OR 1.64 (95% CI 1.00-2.68), p 0.05]. A reduction in S. aureus carriage was observed after influenza vaccination [4 observational studies; OR 0.85 (95% CI 0.78-0.94), p 0.0001]. Based on the Grading of Recommendations Assessment, Development and Evaluation, the quality of evidence was considered low for randomized and very low for non-randomized trials. CONCLUSION Evidence did not suggest long-term effects of pneumococcal vaccinations on S. aureus nasopharyngeal carriage in children, however transient niche changes may occur in infants. Influenza vaccination was related to decreased rates of S. aureus carriage. Data regarding other vaccines is scarce. Further research and ongoing surveillance are needed to monitor colonization changes.
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Zdanowicz K, Lewandowski D, Majewski P, Półkośnik K, Liwoch-Nienartowicz N, Reszeć-Giełażyn J, Lebensztejn DM, Sulik A, Toczyłowski K. Clinical Presentation and Co-Detection of Respiratory Pathogens in Children Under 5 Years with Non-COVID-19 Bacterial and Viral Respiratory Tract Infections: A Prospective Study in Białystok, Poland (2021-2022). Med Sci Monit 2023; 29:e941785. [PMID: 37794657 PMCID: PMC10563589 DOI: 10.12659/msm.941785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/02/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) in children often involve a complex interplay between viruses and bacteria. This study aimed to evaluate clinical presentation in children under 5 years old diagnosed with non-COVID-19 bacterial and viral respiratory tract co-infections between October 2021 and May 2022 in Białystok, Poland. MATERIAL AND METHODS We recruited 100 children under 5 years with RTIs who tested negative for SARS-CoV-2. Nasopharyngeal swabs were screened for 19 viruses and 7 bacterial strains using molecular assays. RESULTS Viral pathogens were detected in 71% of patients and bacterial pathogens were detected in 59%. The most common pathogens were Haemophilus influenzae (n=48), rhinoviruses (n=32), and Streptococcus pneumoniae (n=30). Single pathogens were detected in 36%, dual in 37%, triple in 15%, and quadruple in 2%. Bacterial pathogens were co-detected with viruses in 40 cases, mostly with rhinoviruses (n=15). Two different viruses were found in 14 children and the most common co-detection was adenovirus with rhinovirus (n=5); dyspnea (63% vs 11%) and wheezing (75% vs 22%) were more common in children with human bocavirus. Fever was a common symptom in children with human adenovirus (88% vs 58%). Detection of bacteria and multiple detections were more common in day-care attendees, but were not associated with clinical picture of RTI. CONCLUSIONS Consistent with previous studies, we found a high prevalence of rhinoviruses, despite ongoing implementation of non-pharmaceutical interventions to contain the COVID-19 pandemic. Co-detection of 2 different respiratory pathogens was frequent, but we found no evidence that this was associated with the severity of infections.
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Affiliation(s)
- Katarzyna Zdanowicz
- Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Białystok, Białystok, Poland
| | - Dawid Lewandowski
- Department of Paediatric Infectious Diseases, Medical University of Białystok, Białystok, Poland
| | - Piotr Majewski
- Department of Microbiological Diagnostics and Infectious Immunology, Medical University of Białystok, Białystok, Poland
| | - Kinga Półkośnik
- Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Białystok, Białystok, Poland
| | | | - Joanna Reszeć-Giełażyn
- Department of Medical Pathomorphology, Medical University of Białystok, Białystok, Poland
| | - Dariusz Marek Lebensztejn
- Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Białystok, Białystok, Poland
| | - Artur Sulik
- Department of Paediatric Infectious Diseases, Medical University of Białystok, Białystok, Poland
| | - Kacper Toczyłowski
- Department of Paediatric Infectious Diseases, Medical University of Białystok, Białystok, Poland
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Amari S, Warda K, Bouraddane M, Katfy M, Elkamouni Y, Arsalane L, Zerouali K, Zouhair S, Bouskraoui M. Antibiotic Resistance of Streptococcus pneumoniae in the Nasopharynx of Healthy Children Less than Five Years Old after the Generalization of Pneumococcal Vaccination in Marrakesh, Morocco. Antibiotics (Basel) 2023; 12:antibiotics12030442. [PMID: 36978307 PMCID: PMC10044557 DOI: 10.3390/antibiotics12030442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance (MDR) of S. pneumoniae strains isolated from healthy children throughout the years 2020–2022. Antimicrobial susceptibility testing of S. pneumoniae strains in selected antimicrobials was performed using disk diffusion and E-test methods on bloodMueller–Hinton agar. The antimicrobials tested included oxacillin, amoxicillin, ceftriaxone, norfloxacin, gentamicin, vancomycin, erythromycin, clindamycin, pristinamycin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole. A total of 201 S. pneumoniae strains were isolated from the nasopharynx of healthy children in Marrakesh, Morocco. The highest rate of resistance of S. pneumoniae was found in penicillin (57.2%), followed by tetracycline (20.9%), and erythromycin (17.9%). The rates of resistance to clindamycin, trimethoprim-sulfamethoxazole, and chloramphenicol were 14.9%, 4%, and 1.5%, respectively. All isolates were susceptible to norfloxacin, gentamicin, vancomycin, and pristinamycin. Approximately 17% of all S. pneumoniae strains were resistant to at least three different antibiotic families. This study showed a low rate of antibiotics resistance among nasopharyngeal S. pneumoniae strains, and it is thus essential to monitor S. pneumoniae susceptibility in healthy children.
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Affiliation(s)
- Sara Amari
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
| | - Karima Warda
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Correspondence: ; Tel.:+212-670602083
| | - Majda Bouraddane
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
| | - Mostafa Katfy
- Service de Microbiologie, CHU Ibn Rochd, Casablanca 20000, Morocco
| | - Youssef Elkamouni
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Lamiae Arsalane
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Khalid Zerouali
- Service de Microbiologie, CHU Ibn Rochd, Casablanca 20000, Morocco
| | - Said Zouhair
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Mohamed Bouskraoui
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Service de Pédiatrie, Hôpital Universitaire Mohammed VI, Marrakech 40000, Morocco
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Belachew T, Assefa M, Tefera Z, Fenta A, Biset S. Colonization Rate and Associated Factors of Non-Pathogenic Neisseria Species, and Moraxella catarrhalis Among Healthy School Children in Gondar, Northwest Ethiopia. Infect Drug Resist 2023; 16:369-378. [PMID: 36714354 PMCID: PMC9879043 DOI: 10.2147/idr.s395343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/11/2023] [Indexed: 01/23/2023] Open
Abstract
Background Although commensal Neisseria species inhabiting mucosal surfaces in the upper respiratory tract (URT) are rarely associated with infections, their presence in the area has been linked to the development of immunity against N. meningitidis and the source of antibiotic resistance determinants in pathogenic species. M. catarrhalis in the oropharynx of children is also a predisposing factor for otitis media. As a result, determining the oropharyngeal carriage rate of these commensal species and associated factors among healthy schoolchildren is substantial. Materials and Methods This community-based cross-sectional study was conducted in Gondar, Northwest Ethiopia, from January to April 2019. A multi-stage and simple random sampling technique were used to select schools and participants, respectively. A total of 524 oropharyngeal swabs were collected using cotton swabs. Modified Thayer-Martin media was used for primary bacterial isolation, and battery of biochemical tests was performed to identify species. For frequencies, descriptive statistics were computed and the logistic regression model was used to see the relationship between dependent and independent variables. Results A total of 524 healthy schoolchildren with a mean age of 12.2 ± 2.74 years participated in this study. The overall oropharyngeal carriage rate was 21.8% (114/524). Of these, N. meningitidis, N. lactamica, N. sicca, and M. catarrhalis were identified in 53 (46.5%), 14 (12.3%), 11 (9.6%), and 36 (31.6%) children, respectively. The culture positivity rate was higher at a younger age, which was 8.1%, 11.3%, and 14.9% in ages between 15-18, 11-14, and 7-10, respectively. The oropharyngeal carriage was significantly associated with the number of students per class (>40). Conclusion There is a higher proportion of carriers of commensal N. lactamica and M. catarrhalis in Gondar town schoolchildren. The oropharyngeal carriage rate was associated with a crowded classroom. The characterization of non-pathogenic Neisseria species and M. catarrhalis in the study area can support the diagnosis of patients suspected of having N. meningitis infections.
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Affiliation(s)
- Teshome Belachew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluneh Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Sirak Biset
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Sirak Biset, Tel +251-911-598-568, Email
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Darod HH, Melese A, Kibret M, Mulu W. Throat Swab Culture Positivity and Antibiotic Resistance Profiles in Children 2-5 Years of Age Suspected of Bacterial Tonsillitis at Hargeisa Group of Hospitals, Somaliland: A Cross-Sectional Study. Int J Microbiol 2023; 2023:6474952. [PMID: 37065723 PMCID: PMC10098414 DOI: 10.1155/2023/6474952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/11/2022] [Accepted: 03/17/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Tonsillitis is the third most frequently diagnosed infection in the pediatric age and is associated with significant morbidity and loss of school attendance. Throat swab cultures are useful for the confirmation of children with a clinically suspected tonsillitis. However, Somaliland is one of the underdeveloped countries with a low standard of sanitation and poor health seeking culture. Treatment of tonsillitis with antibiotics is irrational and not empirical. This study determined the bacterial throat swab culture positivity and antibiotic resistance profiles of the bacterial isolates among children 2-5 years of age with suspicion of tonsillitis at Hargeisa Group of Hospital, Somaliland. Materials and Methods A cross-sectional study was conducted from March to July 2020. A total of 374 children from 2 to 5 years of age suspicion of tonsillitis was included using a convenient sampling method. Throat swabs were collected, and bacterial isolation and identification were done using standard bacteriological procedures. Antimicrobial susceptibility testing was done using the disk diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis. Results Overall, 120 (32.1%) (95% CI 27.4-36.8%) of children were positive for bacterial throat cultures. Of these, 23 (19.2%) were mixed bacterial isolates. The most frequent bacterial isolates were beta-hemolytic streptococci 78 (55%), Staphylococcus aureus 42 (29%), and Streptococcus pneumoniae 10 (7%). Isolates revealed 83.3-100% rate of resistance to ampicillin. Beta-hemolytic streptococci isolates were 94.9% resistant to ampicillin. S. aureus was resistant to clarithromycin (38%) while S. pneumoniae isolates were 100% resistant to ampicillin. History of tonsillitis (AOR = 0.12; 95% CI = 0.06-0.21), difficulty in swallowing (AOR = 6.99; 95% CI = 3.56-13.73), and attending schools (AOR = 2.98; 95% CI = 1.64-5.42) were found to be associated with positive throat culture. Conclusions Resistance to ampicillin and MDR among beta-hemolytic streptococci and other isolates of throat colonizers in children with clinically suspected of bacterial tonsillitis are major concerns in Hargeisa, Somaliland. Therefore, treatments of cases are recommended to be guided by regular culture and antimicrobial susceptibility testing to prevent complications of tonsillitis and associated antibiotic resistance.
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Affiliation(s)
- Hamda Hussein Darod
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Addisu Melese
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulugeta Kibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biochemistry and Microbiology, Laboratory of Microbiology, Faculty of Science, Ghent University, Ghent, Belgium
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Tindborg M, Koch A, Andersson M, Juul K, Geisler UW, Soborg B, Michelsen SW. Heart disease among Greenlandic children and young adults: a nationwide cohort study. Int J Epidemiol 2022; 51:1568-1580. [PMID: 35201265 PMCID: PMC9558066 DOI: 10.1093/ije/dyac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The incidences of heart disease (HD) and congenital heart disease (CHD) among Inuit in Greenland (GL) and Denmark (DK) are unknown. This study aims to estimate incidence rates (IRs) of HD and CHD among the young Inuit populations in Greenland and Denmark compared with rates among young non-Inuit populations in the same countries. METHODS A register-based nationwide cohort including all individuals living in Greenland and Denmark from birth to age <40 years through 1989-2014 was formed. Ethnicity was considered Inuit/mixed if at least one parent was registered as being born in Greenland. Information on HD and CHD hospitalization was obtained from national inpatient registers using ICD-8 and ICD-10 codes. RESULTS HD IR was lower among individuals living in Greenland compared with those living in Denmark, [73.35GL (95% confidence interval (CI) 68.07 to 79.03)] vs [88.07DK (95% CI 87.38 to 88.76)], whereas CHD IRs were almost similar in the two countries [IR 34.44GL (95% CI 30.89 to 38.40) vs IR 34.67DK (95% CI 34.24 to 35.10)]. Being of Inuit/mixed ethnicity was associated with an increased risk of both HD and CHD compared with non-Inuit in Greenland and Denmark [adjusted hazard ratio HD 2.07GL (95% CI 1.25 to 3.42)] and CHD [2.92GL (95% CI 1.34 to 6.38)]. CONCLUSION HD IR was lower in individuals living in Greenland compared with individuals living in Denmark, whereas the CHD IRs were almost the same for both countries. However, the risk of HD including CHD was higher among individuals of Inuit/mixed ethnicity compared with non-Inuit in both countries, suggesting a role of ethnicity among children and younger adults.
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Affiliation(s)
- Marie Tindborg
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Paediatric and Adolescent Medicine, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Anders Koch
- Department of Internal Medicine, Queen Ingrids Hospital, Nuuk, Greenland.,Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark.,Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark.,Ilisimatusarfik, University of Greenland, Nuuk, Greenland
| | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Klaus Juul
- Department of Paediatric and Adolescent Medicine, Paediatric Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark
| | | | - Bolette Soborg
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Sascha Wilk Michelsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Paediatric and Adolescent Medicine, Rigshospitalet University Hospital, Copenhagen, Denmark
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Neal EFG, Chan J, Nguyen CD, Russell FM. Factors associated with pneumococcal nasopharyngeal carriage: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000327. [PMID: 36962225 PMCID: PMC10021834 DOI: 10.1371/journal.pgph.0000327] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022]
Abstract
Pneumococcal disease is a major contributor to global childhood morbidity and mortality and is more common in low- and middle-income countries (LMICs) than in high-income countries. Pneumococcal carriage is a prerequisite for pneumococcal disease. Pneumococcal conjugate vaccine reduces vaccine-type carriage and disease. However, pneumococcal carriage and disease persist, and it is important to identify other potentially modifiable factors associated with pneumococcal carriage and determine if risk factors differ between low, middle, and high-income countries. This information may help inform pneumococcal disease prevention programs. This systematic literature review describes factors associated with pneumococcal carriage stratified by country income status and summarises pneumococcal carriage rates for included studies. We undertook a systematic search of English-language pneumococcal nasopharyngeal carriage studies up to 30th June 2021. Peer-reviewed studies reporting factors associated with overall pneumococcal nasopharyngeal carriage in healthy, community-based study populations were eligible for inclusion. Two researchers independently reviewed studies to determine eligibility. Results are presented as narrative summaries. This review is registered with PROSPERO, CRD42020186914. Eighty-two studies were included, and 46 (56%) were conducted in LMICs. There was heterogeneity in the factors assessed in each study. Factors positively associated with pneumococcal carriage in all income classification were young age, ethnicity, symptoms of respiratory tract infection, childcare attendance, living with young children, poverty, exposure to smoke, season, and co-colonisation with other pathogens. Breastfeeding and antibiotic use were protective against carriage in all income classifications. Median (interquartile range) pneumococcal carriage rates differed by income classification, ranging from 51% (19.3-70.2%), 38.5% (19.3-51.6%), 31.5% (19.0-51.0%), 28.5% (16.8-35.4%), (P = 0.005) in low-, lower-middle, upper-middle, and high-income classifications, respectively. Our findings suggest that where measured, factors associated with pneumococcal nasopharyngeal carriage are similar across income classifications, despite the highest pneumococcal carriage rates being in low-income classifications. Reducing viral transmission through vaccination and public health interventions to address social determinants of health would play an important role.
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Affiliation(s)
- Eleanor Frances Georgina Neal
- Infection & Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Jocelyn Chan
- Infection & Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Cattram Duong Nguyen
- Infection & Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Fiona Mary Russell
- Infection & Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
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Nikolova KA, Andersson M, Slotved HC, Koch A. Effectiveness of the 13-Valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease in Greenland. Vaccines (Basel) 2021; 9:vaccines9101123. [PMID: 34696230 PMCID: PMC8537731 DOI: 10.3390/vaccines9101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in 2010 to the childhood vaccination program in Greenland. This study aimed to estimate the effectiveness of the PCV13 on the incidence of invasive pneumococcal disease (IPD) in children and in adults in Greenland. IPD cases from the pre-PCV13 period (January 1995-September 2010) were compared with the post-PCV13 period (September 2010-October 2020). Register data were collected from laboratory records, IPD reports, the national registry on admissions, and medical files. A total of 295 IPD cases were identified in the study period. Overall IPD incidence rate (IR) declined from the pre-PCV13 period to the post-PCV13 period (IR 23.3 to 15.3 per 100,000 person years). Overall IPD incidence among children decreased significantly, whereas overall IPD incidence among the elderly increased significantly. During the post-PCV13 period, the incidence of vaccine serotype (VT) IPD decreased in all ages, while the incidence of non-vaccine serotype (NVT) IPD increased. This increase was most substantial among elderly ≥60 years. In conclusion, the PCV13 has reduced incidence rates of IPD in Greenland. However, the increase in NVT IPD among the elderly is noteworthy, and sup-ports continued surveillance of IPD in the population of Greenland.
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Affiliation(s)
- Kristiana Alexandrova Nikolova
- Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; (M.A.); (A.K.)
- Department of Infectious Diseases, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
- Correspondence:
| | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; (M.A.); (A.K.)
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark;
| | - Anders Koch
- Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; (M.A.); (A.K.)
- Department of Infectious Diseases, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark
- Department of Infectious Disease Epidemiology & Prevention, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
- Ilisimatusarfik University of Greenland, Manutooq 1, 3905 Nuuk, Greenland
- Department of Internal Medicine, Queen Ingrids Hospital, 3900 Nuuk, Greenland
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Gámez G, Rojas JP, Cardona S, Castillo Noreña JD, Palacio MA, Mejía LF, Torres JL, Contreras J, Muñoz LM, Criales J, Vélez LF, Forero AM, Zúñiga YA, Cuastumal ME, Acevedo LJ, Molina ÁDJ, Bolivar JA, Gómez-Mejia A, Morales JL, Hammerschmidt S. Factors Associated with Streptococcus pneumoniae Nasopharyngeal Carriage and Antimicrobial Susceptibility among Children Under the Age of 5 Years in the Southwestern Colombia. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1731343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Objective This work aimed to evaluate the factors associated with Streptococcus pneumoniae nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in southwestern Colombia, 2019.
Methods A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage.
Results A total of 452 children under the age of 5 years were examined in which 41.8% carried S. pneumoniae. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%).
Conclusion The 41.8% of participants carrying S. pneumoniae show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.
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Affiliation(s)
- Gustavo Gámez
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Juan Pablo Rojas
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
- School of Health, Valle University, Cali, Colombia
| | - Santiago Cardona
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | | | - María Alejandra Palacio
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Luis Fernando Mejía
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - José Luis Torres
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | | | - Laura Mery Muñoz
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Javier Criales
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Luis Felipe Vélez
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Angélica María Forero
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Yulieth Alexandra Zúñiga
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - María Eugenia Cuastumal
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Leidy Johanna Acevedo
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Álvaro de Jesús Molina
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Johan Alexis Bolivar
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Alejandro Gómez-Mejia
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Jessica Lorena Morales
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
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Alsharif SM, El-Sayed WS, Hanafy AM. Geographic distribution and prevalence of potential asymptomatic Staphylococcus spp. in the nasopharyngeal cavity of elementary school boys at Al-Madinah, KSA. JOURNAL OF TAIBAH UNIVERSITY FOR SCIENCE 2021. [DOI: 10.1080/16583655.2021.1892991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sultan M. Alsharif
- Department of Biology, College of Science, Taibah University, Al-Madinah, Kingdom of Saudi Arabia
| | - Wael S. El-Sayed
- Department of Microbiology, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Ahmed M. Hanafy
- Department of Biology, College of Science, Taibah University, Al-Madinah, Kingdom of Saudi Arabia
- Department of Microbiology, Faculty of Science, Ain Shams University, Cairo, Egypt
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11
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Ceyhan M, Karadag-Oncel E, Hascelik G, Ustundag G, Gurbuz V, Samlioglu P, Yilmaz N, Ozsurekci Y, Yilmaz E, Aykac K, Oz FN, Uzum O, Orsdemir-Hortu H, Tanir G, Yilmaz-Ciftdogan D, Kurugol Z. Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children aged less than five years. Vaccine 2021; 39:2041-2047. [PMID: 33741188 DOI: 10.1016/j.vaccine.2021.03.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 03/07/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE In Turkey, pneumococcal conjugate vaccine (PCV) was introduced to the national immunization program as PCV7 in 2008, and was replaced with PCV13 in 2011. The aim of the study was to demonstrate the pneumococcal carriage rate and the serotype distribution in healthy children under 5 years in Turkey who were vaccinated with PCV13. METHODS We conducted a cross-sectional study including the collection of questionnaire data and nasopharyngeal (NP) specimens among children aged <5 years from five centers from March 2019 to March 2020. Pneumococcal isolates were identified using optochin sensitivity and bile solubility. Serotyping was performed using a latex agglutination kit and Quellung reaction. RESULTS NP swab samples were collected from 580 healthy children. The observed overall carriage rate was 17.8%. None of the hypothesised predictors of S. pneumoniae carriage, except maternal education level was statistically significant (p = 0.017). High maternal education level appeared to decrease the risk (lower vs. higher maternal education OR: 1.992 [95% CI; 1.089-3.643], p = 0.025). The overall NP S. pneumoniae carriage prevalence for the PCV13-vaccinated children was 17.8% (103/580). The most common serotypes detected were serotype 15B (n = 10, 9.7%), serotype 23F (n = 9, 8.7%), serotype 23A (n = 9, 8.7%), serotype 11A (n = 7, 6.7%), serotype 19F (n = 5, 4.8%) and serotype 15F (n = 5, 4.8%). Of the isolates, 28 (27.2%) were in PCV13 vaccine strains (VSs), and 75 (72.8%) strains were non-VS. The serotype coverage rate was 27.2% for PCV13. CONCLUSION The overall S. pneumoniae carriage rate was higher than in earlier studies from Turkey. Post-vaccine era studies from around the world have reported a decrease in VS serotypes and a 'serotype replacement' to non-VS serotypes, as we determined in our study.
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Affiliation(s)
- Mehmet Ceyhan
- Hacettepe University School of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Eda Karadag-Oncel
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Infectious Diseases, İzmir, Turkey
| | - Gulsen Hascelik
- Hacettepe University School of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Gulnihan Ustundag
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Infectious Diseases, İzmir, Turkey.
| | - Venhar Gurbuz
- Hacettepe University School of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Pinar Samlioglu
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Medical Microbiology, İzmir, Turkey
| | - Nisel Yilmaz
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Medical Microbiology, İzmir, Turkey
| | - Yasemin Ozsurekci
- Hacettepe University School of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Elif Yilmaz
- Ege University School of Medicine, Department of Pediatric Infectious Diseases, İzmir, Turkey
| | - Kubra Aykac
- University of Health Sciences, Ankara Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Fatma Nur Oz
- University of Health Sciences, Sami Ulus Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Ozlem Uzum
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatrics, İzmir, Turkey
| | - Hacer Orsdemir-Hortu
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatrics, İzmir, Turkey
| | - Gonul Tanir
- University of Health Sciences, Sami Ulus Training and Research Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey
| | - Dilek Yilmaz-Ciftdogan
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Infectious Diseases, İzmir, Turkey
| | - Zafer Kurugol
- Ege University School of Medicine, Department of Pediatric Infectious Diseases, İzmir, Turkey
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12
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Nasopharyngeal colonization with pathobionts is associated with susceptibility to respiratory illnesses in young children. PLoS One 2020; 15:e0243942. [PMID: 33306743 PMCID: PMC7732056 DOI: 10.1371/journal.pone.0243942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022] Open
Abstract
Some children are more susceptible to viral and bacterial respiratory infections in the first few years of life than others. However, the factors contributing to this susceptibility are incompletely understood. In a retrospective analysis of clinical samples collected from a prospectively-enrolled cohort of 358 children we sought associations between physician-attended illness visits and bacterial colonization in the first five years of life. A subset of children was identified by unsupervised clustering analysis as infection and allergy prone (IAP). Several respiratory infection- and allergy-mediated illnesses co-occurred at higher rates in IAP children, while the rates of other illnesses were not significantly different between the groups. Analyses of nasopharyngeal (NP) pathobionts and microbiota commensals showed that early age of first colonization with pathobionts Streptococcus pneumonia, non-typeable Haemophilus influenzae, and Moraxella catarrhalis was associated with IAP children, and particularly Moraxella abundance was negatively associated with NP microbiome diversity. We conclude that mucosal pathobiont exposures in early life can influence susceptibility to respiratory illnesses in children.
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Isaieva HO, Mishyna MM, Gonchar MO, Logvinova OL, Basiuk MA. Microorganisms causing respiratory diseases in children in relation to age and diagnosis. REGULATORY MECHANISMS IN BIOSYSTEMS 2020. [DOI: 10.15421/022085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Community-acquired pneumonia (CAP) in children is still one of the leading causes of morbidity and mortality, especially in developing countries. The World Health Organization (WHO) has reported that pneumonia accounts for 15% of all deaths of children under 5 years old. The aim of the present study was to find out the predominance of microorganisms in the respiratory tract in children. 334 strains of microorganisms were isolated: Gram-positive – 293 strains, Gram-negative – 41. From the pharynx 183 strains were isolated, from the nose – 94, from sputum – 57. Among Gram-positive microorganisms the following were isolated: Staphylococcus aureus 44 strains of microorganisms, S. epidermidis – 75, Group A β-hemolytic streptococci – 39, viridans streptococci – 55, Streptococcus pneumoniae – 34, Enterococcus faecalis – 2, Candida spp. – 38, Corynebacterium pseudodiphthericum – 6. Among Gram-negative microorganisms the following were isolated: Escherichia coli 4 strains of microorganisms, Klebsiella pneumoniae – 13, Pseudomonas aeruginosa – 6, Haemophilus influenzae – 11, Enterobacter cloacae – 7. Children were divided by age and diagnosis into four groups: I group – children with acute bronchitis (0–5 years of age), II group – children with acute bronchitis (5–18 years of age), III group – children with CAP (0–5 years of age), IV group – children with CAP (5–18 years of age). Materials used in the research – nasal swabs, throat swabs and sputum. Microorganisms were isolated and identified using standard microbiological methods. S. aureus was the predominant microorganism isolate from the pharynx in children with bronchitis (0–5 years). Group A β-hemolytic streptococci were isolated most often from the pharynx in children with bronchitis older than 5 years and in children with CAP less than 5 years of age. S. pneumoniae was most often isolated from the pharynx in children older than 5 years of age with CAP. S. aureus was the main microorganism, isolated from the nose in children with bronchitis in all age groups; in patients with CAP it was the predominant microorganism in children older than 5 years of age. S. aureus was the predominant microorganism, isolated from sputum in children with bronchitis older than 5 years. S. pneumoniae was the predominant microorganism, isolated from sputum in children with CAP older than 5 years. The research showed that S. pneumoniae is still one of the main pathogens that cause CAP in school aged children.
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Wouters I, Desmet S, Van Heirstraeten L, Herzog SA, Beutels P, Verhaegen J, Goossens H, Van Damme P, Malhotra-Kumar S, Theeten H. How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018. ACTA ACUST UNITED AC 2020; 25. [PMID: 32046817 PMCID: PMC7014673 DOI: 10.2807/1560-7917.es.2020.25.5.1900303] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background The current carriage study was set up to reinforce surveillance during/after the PCV13-to-PCVC10 switch in Belgium. Aim This observational study monitored carriage of Streptococcus pneumoniae (Sp) serotypes, particularly those no longer covered (3, 6A, 19A), as well as Haemophilus influenzae (Hi), because PCV10 contains the non-typeable Hi protein D. Methods A total of 2,615 nasopharyngeal swabs from children (6–30 months old) attending day care were collected in three periods over 2016–2018. Children’s demographic and clinical characteristics and vaccination status were obtained through a questionnaire. Sp and Hi were identified by culture and PCR. Pneumococcal strains were tested for antimicrobial (non-)susceptibility by disc diffusion and serotyped by Quellung-reaction (Quellung-reaction and PCR for serotypes 3, 6A, 19A). Results The carriage prevalence of Sp (> 75%) remained stable over the successive periods but that of Hi increased (87.4%, 664 Hi-carriers/760 in 2016 vs 93.9%, 895/953 in 2017–2018). The proportion of non-PCV13 vaccine serotypes decreased (94.6%, 438 isolates/463 in 2016 vs 89.7%, 599/668 in 2017–2018) while that of PCV13-non-PCV10 vaccine serotypes (3 + 6A + 19A) increased (0.9%, 4 isolates/463 in 2016 vs 7.8%, 52/668 in 2017–2018), with serotype 19A most frequently identified (87.9%, 58/66 isolates). Non-susceptibility of pneumococci against any of the tested antibiotics was stable over the study period (> 44%). Conclusions During and after the PCV13-to-PCV10 vaccine switch, the proportion of non-PCV13 serotypes decreased, mainly due to a serotype 19A carriage prevalence increase. These results complement invasive pneumococcal disease surveillance data, providing further basis for pneumococcal vaccination programme policy making.
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Affiliation(s)
- Ine Wouters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Stefanie Desmet
- Reference Centre for Pneumococci, University Hospitals Leuven, Leuven, Belgium
| | - Liesbet Van Heirstraeten
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Sereina A Herzog
- Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Wilrijk, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Wilrijk, Belgium
| | - Jan Verhaegen
- Reference Centre for Pneumococci, University Hospitals Leuven, Leuven, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Heidi Theeten
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
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- The members of the NPcarriage Study Group are listed at the end of the article
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15
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Fjeldhøj S, Fuglsang E, Sørensen CA, Frøkiær H, Krogfelt KA, Laursen RP, Slotved HC. Factors influencing PCV13 specific antibody response in Danish children starting in day care. Sci Rep 2020; 10:6179. [PMID: 32277105 PMCID: PMC7148338 DOI: 10.1038/s41598-020-63080-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/24/2020] [Indexed: 11/25/2022] Open
Abstract
This study examines different factors influencing the 13-valent pneumococcal conjugate vaccine (PCV13) specific antibody response in 8–13 months old Danish children starting in day care. We present secondary findings to the ProbiComp study, which included nose swabs, buccal swabs and blood samples from the children before entering day care (baseline) and again after 6 months. Pneumococci isolated from nose swabs were identified by latex agglutination kit and Quellung reaction. Luminex-based assay was used for antibody measurements against specific anti-pneumococcal capsular IgG. Buccal gene expression was analyzed by qPCR. Statistical analyses were performed in R and included Pearson’s Chi-squared test, Welch two sample t-test and linear regression models. The PCV13 antibody response was unaffected by whether the children were carriers or non-carriers of any pneumococcal serotype. Having siblings increased the risk of carrying serotype 21 before day care (p = 0.020), and having siblings increased the PCV13 antibody response at the end of study (p = 0.0135). Hepatitis B-vaccination increased the PCV13 antibody response before day care attendance (p = 0.005). The expression of IL8 and IL1B was higher in children carrying any pneumococcal serotype at baseline compared to non-carriers (p = 0.0125 and p = 0.0268 respectively).
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Affiliation(s)
- Sine Fjeldhøj
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Copenhagen, 2300, Denmark
| | - Eva Fuglsang
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, 1870, Denmark
| | - Camilla Adler Sørensen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Copenhagen, 2300, Denmark
| | - Hanne Frøkiær
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, 1870, Denmark
| | - Karen Angeliki Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Copenhagen, 2300, Denmark.,Department of Science and Environment, Roskilde University, Roskilde, 4000, Denmark
| | - Rikke Pilmann Laursen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, 1958, Denmark
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Copenhagen, 2300, Denmark.
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16
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Neal EFG, Nguyen CD, Ratu FT, Dunne EM, Kama M, Ortika BD, Boelsen LK, Kado J, Tikoduadua L, Devi R, Tuivaga E, Reyburn RC, Satzke C, Rafai E, Mulholland EK, Russell FM. Factors associated with pneumococcal carriage and density in children and adults in Fiji, using four cross-sectional surveys. PLoS One 2020; 15:e0231041. [PMID: 32236150 PMCID: PMC7112956 DOI: 10.1371/journal.pone.0231041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/13/2020] [Indexed: 01/26/2023] Open
Abstract
This study describes predictors of pneumococcal nasopharyngeal carriage and density in Fiji. We used data from four annual (2012-2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10) in October 2012. Infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and their caregivers participated. Pneumococci were detected and quantified using lytA qPCR, with molecular serotyping by microarray. Logistic and quantile regression were used to determine predictors of pneumococcal carriage and density, respectively. There were 8,109 participants. Pneumococcal carriage was negatively associated with years post-PCV10 introduction (global P<0.001), and positively associated with indigenous iTaukei ethnicity (aOR 2.74 [95% CI 2.17-3.45] P<0.001); young age (infant, toddler, and child compared with caregiver participant groups) (global P<0.001); urban residence (aOR 1.45 [95% CI 1.30-2.57] P<0.001); living with ≥2 children <5 years of age (aOR 1.42 [95% CI 1.27-1.59] P<0.001); low family income (aOR 1.44 [95% CI 1.28-1.62] P<0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57-2.01] P<0.001). Predictors were similar for PCV10 and non-PCV10 carriage, except PCV10 carriage was negatively associated with PCV10 vaccination (0.58 [95% CI 0.41-0.82] P = 0.002) and positively associated with exposure to household cigarette smoke (aOR 1.21 [95% CI 1.02-1.43] P = 0.031), while there was no association between years post-PCV10 introduction and non-PCV10 carriage. Pneumococcal density was positively associated with URTI symptoms (adjusted median difference 0.28 [95% CI 0.16, 0.40] P<0.001) and toddler and child, compared with caregiver, participant groups (global P = 0.008). Predictors were similar for PCV10 and non-PCV10 density, except infant, toddler, and child participant groups were not associated with PCV10 density. PCV10 introduction was associated with reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. However, after adjustment iTaukei ethnicity was positively associated with pneumococcal carriage compared with Fijians of Indian Descent, despite similar PCV10 coverage rates.
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Affiliation(s)
- Eleanor F. G. Neal
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- * E-mail:
| | - Cattram D. Nguyen
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | | | - Eileen M. Dunne
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Mike Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - Belinda D. Ortika
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
| | - Laura K. Boelsen
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
| | - Joseph Kado
- Telethon Kids Institute, University of Western Australia, Western Australia, Australia
- College of Medicine Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | | | - Rachel Devi
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Rita C. Reyburn
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
| | - Catherine Satzke
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Eric Rafai
- Ministry of Health and Medical Services, Suva, Fiji
| | - E. Kim Mulholland
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fiona M. Russell
- Infection & Immunity, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
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17
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Dayie NTKD, Tettey EY, Newman MJ, Bannerman E, Donkor ES, Labi AK, Slotved HC. Pneumococcal carriage among children under five in Accra, Ghana, five years after the introduction of pneumococcal conjugate vaccine. BMC Pediatr 2019; 19:316. [PMID: 31488088 PMCID: PMC6727402 DOI: 10.1186/s12887-019-1690-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/26/2019] [Indexed: 12/03/2022] Open
Abstract
Background The study objective was to determine the carriage and serotype distribution of Streptococcus pneumoniae among children in Accra, Ghana, five years after the introduction of the pneumococcal conjugate vaccine (PCV-13) in 2012. Methods Nasopharyngeal swab samples were collected from 410 children below 5 years of age in Accra, Ghana, from September to December, 2016. Pneumococcal isolates were identified by optochin sensitivity and bile solubility. Serotyping was performed using the latex agglutination kit and Quellung reaction. The isolates were furthermore tested for antimicrobial susceptibility for different antimicrobials, including penicillin (PEN). Twelve isolates including seven non-typeable (NT) isolates were characterized using whole-genome sequencing analysis (WGS). Results The overall carriage prevalence was found to be 54% (95% CI, 49–59%), and 20% (95% CI, 49–59%) of the children were carrying PCV-13 included serotypes, while 37% (95% CI, 33–42%) of the children were carrying non-PCV-13 serotypes. Based on the serotype distribution, 33% of all observed serotypes were included in PCV-13 while 66% were non-PCV-13 serotypes. The dominating non-PCV-13 serotypes were 23B, 16F, and 11A followed by PCV-13 serotypes 23F and 19F. The PCV-13 covers the majority of resistant isolates in Accra. A proportion of 22.3% of the isolates showed intermediate resistance to penicillin G, while only one isolate showed full resistance. Forty-five isolates (20.5%) were defined as multidrug-resistant (MDR) as they were intermediate/resistant to three or more classes of antimicrobials. Of the seven NT isolates characterized by WGS, four showed highest match to genotype 38, while the remaining three showed highest match to genotype 14. Four MDR serotype 19A isolates were found to be MLST 320. Conclusion PCV-13 introduced in Ghana did not eliminate PCV-13 covered serotypes, and the carriage rate of 54% in this study is similar to carriage studies from pre PCV-13 period. However, the penicillin non-susceptible isolates have been reduced from 45% of carriage isolates before PCV-13 introduction to 22.3% of the isolates in this study. Continuous monitoring of serotype distribution is important, and in addition, an evaluation of an alternative vaccination schedule from 3 + 0 to 2 + 1 will be important to consider. Electronic supplementary material The online version of this article (10.1186/s12887-019-1690-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicholas T K D Dayie
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Elizabeth Y Tettey
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Mercy J Newman
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Elizabeth Bannerman
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Eric S Donkor
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Appiah-Korang Labi
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen, Denmark.
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18
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Direct interactions with influenza promote bacterial adherence during respiratory infections. Nat Microbiol 2019; 4:1328-1336. [PMID: 31110359 DOI: 10.1038/s41564-019-0447-0] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 04/04/2019] [Indexed: 02/06/2023]
Abstract
Epidemiological observations and animal models have long shown synergy between influenza virus infections and bacterial infections. Influenza virus infection leads to an increase in both the susceptibility to secondary bacterial infections and the severity of the bacterial infections, primarily pneumonias caused by Streptococcus pneumoniae or Staphylococcus aureus. We show that, in addition to the widely described immune modulation and tissue-remodelling mechanisms of bacterial-viral synergy, the virus interacts directly with the bacterial surface. Similar to the recent observation of direct interactions between enteric bacteria and enteric viruses, we observed a direct interaction between influenza virus on the surface of Gram-positive, S. pneumoniae and S. aureus, and Gram-negative, Moraxella catarrhalis and non-typeable Haemophilus influenzae, bacterial colonizers and pathogens in the respiratory tract. Pre-incubation of influenza virus with bacteria, followed by the removal of unbound virus, increased bacterial adherence to respiratory epithelial cells in culture. This result was recapitulated in vivo, with higher bacterial burdens in murine tissues when infected with pneumococci pre-incubated with influenza virus versus control bacteria without virus. These observations support an additional mechanism of bacteria-influenza virus synergy at the earliest steps of pathogenesis.
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Probiotics and carriage of Streptococcus pneumoniae serotypes in Danish children, a double-blind randomized controlled trial. Sci Rep 2018; 8:15258. [PMID: 30323328 PMCID: PMC6189121 DOI: 10.1038/s41598-018-33583-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 10/01/2018] [Indexed: 12/22/2022] Open
Abstract
This study examined the carriage of Streptococcus pneumoniae in healthy Danish children aged 8–19 months and assessed the effect of the probiotics Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis on the pneumococcal carriage during daycare enrolment. Potential risk factors of pneumococcal carriage were analysed and the carriage study was compared with registered invasive pneumococcal disease (IPD) data. This study is a part of the ProbiComp study, which was a double-blind, randomized controlled trial, including 290 children allocated to probiotics or placebo for 6 months and recruited during two autumn seasons (2014/2015). Pneumococci were identified by optochin sensitivity, bile solubility, α-hemolysis and/or capsular reaction. Serotyping was performed by latex agglutination kit and Quellung reaction. The carriage rate of S. pneumoniae was 26.0% at baseline and 67.4% at the end of intervention. No significant difference was observed between the placebo group and the probiotics group (p = 0.508). Children aged 8–19 months were carriers of non-pneumococcal vaccine serotypes causing IPD in children aged 0–4 years. However, serotypes causing most IPD cases in Danish elderly were either not found or found with low prevalence suggesting that children are not the main reservoir of those serotypes and other age groups need to be considered as carriers.
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Andrade DC, Borges IC, Bouzas ML, Oliveira JR, Käyhty H, Ruuskanen O, Nascimento-Carvalho C. 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; 50:705-713. [PMID: 29688138 DOI: 10.1080/23744235.2018.1463451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND We studied Immunoglobulin G (IgG) antibody responses against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in young children with acute viral type respiratory infection and analyzed the findings in a multivariate model including age, nasopharyngeal carriage of the tested bacteria and pneumococcal vaccination. METHODS We included 227 children aged 6-23 months with acute respiratory infection. Nasopharyngeal aspirates were tested for bacterial carriage through detection of messenger RNA (mRNA) transcript with nCounter analysis. Acute and convalescent serum samples were tested for IgG antibody response against eight pneumococcal proteins, three proteins from H. influenzae and five proteins from M. catarrhalis in a fluorescent multiplex immunoassay. RESULTS A two-fold or greater increase in antibodies to S. pneumoniae, H. influenzae and M. catarrhalis was detected in 27.8, 9.7 and 14.1%, respectively. Nasopharyngeal carriage of each of the studied bacteria was not associated with antibody response detection against each respective bacterium. Furthermore, neither age nor pneumococcal vaccination were independently associated to detection of antibody response against the studied bacteria. Children who carried H. influenzae had higher frequency of colonization by M. catarrhalis (175 [80.3%] vs. 2 [22.2%]; p < .001) than those without H. influenzae. Also, children with acute otitis media tended to have higher frequency of antibody response to S. pneumoniae. CONCLUSION Nasopharyngeal colonization by S. pneumoniae, H. influenzae and M. catarrhalis did not induce significant increases in antibody levels to these bacteria. Carriage of pathogenic bacteria in the nasopharynx is not able to elicit antibody responses to protein antigens similar to those caused by symptomatic infections.
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Affiliation(s)
- Dafne C Andrade
- a Postgraduate Programme in Health Sciences , Federal University of Bahia School of Medicine , Salvador , Brazil
| | - Igor C Borges
- a Postgraduate Programme in Health Sciences , Federal University of Bahia School of Medicine , Salvador , Brazil
| | - Maiara L Bouzas
- a Postgraduate Programme in Health Sciences , Federal University of Bahia School of Medicine , Salvador , Brazil
| | - Juliana R Oliveira
- a Postgraduate Programme in Health Sciences , Federal University of Bahia School of Medicine , Salvador , Brazil
| | - Helena Käyhty
- b Department of Vaccinations and Immune Protection , National Institute for Health and Welfare , Helsinki , Finland
| | - Olli Ruuskanen
- c Department of Paediatrics , Turku University and University Hospital , Turku , Finland
| | - Cristiana Nascimento-Carvalho
- d Postgraduate Programme in Health Sciences, Department of Paediatrics , Federal University of Bahia School of Medicine , Salvador , Brazil
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Navne JE, Koch A, Slotved HC, Andersson M, Melbye M, Ladefoged K, Børresen M. Effect of the 13-valent pneumococcal conjugate vaccine on nasopharyngeal carriage by respiratory pathogens among Greenlandic children. Int J Circumpolar Health 2018; 76:1309504. [PMID: 28467237 PMCID: PMC5497538 DOI: 10.1080/22423982.2017.1309504] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: In 2010, Greenland introduced the 13-valent pneumococcal conjugate vaccine (Prevnar 13®– PCV-13) in the childhood immunisation program. The authors aimed to evaluate the impact of PCV-13 on nasopharyngeal carriage of bacteria frequently associated with respiratory infections in children. Method: In 2013 a cross-sectional population-based study of nasopharyngeal carriage was conducted among Greenlandic children aged 0–6 years and results were compared with an equivalent study from 2011. Nasopharyngeal swab samples were tested for Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus. Pneumococcal serotyping was performed by Quellung reaction and serotype-specific antisera. Statistical analysis included logistic regression models, adjusting for known risk factors. Result: A total of 377 nasopharyngeal samples were collected. Overall carriage rate of S. pneumoniae remained unchanged from 2011 to 2013 (51% and 56%, p=0.13), but significant serotype shifts were observed among both vaccinated and unvaccinated children with marked reductions in carriage of vaccine-type pneumococci, counterbalanced by increasing carriage of non-vaccine types. Carriage rate of S. aureus decreased significantly among vaccinated children whereas that of M. catarrhalis increased. Conclusion: PCV-13 introduction in Greenland is associated with significant changes in nasopharyngeal bacterial carriage. Continued surveillance is warranted to clarify whether these changes are persistent, and affect the pattern of respiratory and invasive diseases in Greenland.
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Affiliation(s)
- Johan Emdal Navne
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark
| | - Anders Koch
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark
| | - Hans-Christian Slotved
- b Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen , Denmark
| | - Mikael Andersson
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark
| | - Mads Melbye
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark
| | - Karin Ladefoged
- c Department of Internal Medicine , Queen Ingrids Hospital , Nuuk , Greenland
| | - Malene Børresen
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen , Denmark.,d Department of Pediatrics , Rigshospitalet , Copenhagen , Denmark
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Nosocomial Outbreak of Upper Respiratory Tract Infection With β-Lactamase-Negative Ampicillin-Resistant Nontypeable Haemophilus influenzae. Infect Control Hosp Epidemiol 2018; 39:652-659. [PMID: 29611493 DOI: 10.1017/ice.2018.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVETo describe the epidemiologic features of an outbreak of an acute respiratory tract infection (ARI) caused by β-lactamase-negative ampicillin-resistant (BLNAR) nontypeable Haemophilus influenzae (NTHi) in an acute-care ward.DESIGNCross-sectional case-control study.SETTINGAn acute-care ward (ward A) in a general hospital of Kochi in western Japan.METHODSPatients who shared a room with an index patient and all staff in ward A were screened and followed from July 1 to August 31, 2015. Sputum or throat swab samples were collected from participants and tested by culture and polymerase chain reaction (PCR). The association between detected pathogens and ARI development among all participants was examined. A case-control study was conducted to identify risk factors for disease.RESULTSIn total, 78 participants, including the index patient, were enrolled. Of all participants, 27 (34.6%) developed mild respiratory symptoms during a 3-week period: 24 were diagnosed as upper respiratory tract infections, and 3 were diagnosed as lower respiratory tract infections. The presence of BLNAR NTHi was confirmed in 13 participants, and multilocus sequence typing demonstrated that these isolates belonged to sequence type 159. All isolates showed identical pulsed-field gel electrophoresis patterns. The presence of BLNAR NTHi was strongly associated with ARI development, whereas viruses were not associated with the disease. Multivariate analyses demonstrated that a history of contact with the index patient was independently associated with ARI caused by BLNAR NTHi.CONCLUSIONSBLNAR NTHi has the potential to cause upper respiratory tract infections among adults and to spread rapidly in hospital settings.Infect Control Hosp Epidemiol 2018;39:652-659.
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Hakansson AP, Orihuela CJ, Bogaert D. Bacterial-Host Interactions: Physiology and Pathophysiology of Respiratory Infection. Physiol Rev 2018; 98:781-811. [PMID: 29488821 PMCID: PMC5966719 DOI: 10.1152/physrev.00040.2016] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023] Open
Abstract
It has long been thought that respiratory infections are the direct result of acquisition of pathogenic viruses or bacteria, followed by their overgrowth, dissemination, and in some instances tissue invasion. In the last decades, it has become apparent that in contrast to this classical view, the majority of microorganisms associated with respiratory infections and inflammation are actually common members of the respiratory ecosystem and only in rare circumstances do they cause disease. This suggests that a complex interplay between host, environment, and properties of colonizing microorganisms together determines disease development and its severity. To understand the pathophysiological processes that underlie respiratory infectious diseases, it is therefore necessary to understand the host-bacterial interactions occurring at mucosal surfaces, along with the microbes inhabiting them, during symbiosis. Current knowledge regarding host-bacterial interactions during asymptomatic colonization will be discussed, including a plausible role for the human microbiome in maintaining a healthy state. With this as a starting point, we will discuss possible disruptive factors contributing to dysbiosis, which is likely to be a key trigger for pathobionts in the development and pathophysiology of respiratory diseases. Finally, from this renewed perspective, we will reflect on current and potential new approaches for treatment in the future.
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Affiliation(s)
- A P Hakansson
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
| | - C J Orihuela
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
| | - D Bogaert
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
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Brini I, Guerrero A, Hannachi N, Bouguila J, Orth-Höller D, Bouhlel A, Boughamoura L, Hetzer B, Borena W, Schiela B, Von Laer D, Boukadida J, Stoiber H. Epidemiology and clinical profile of pathogens responsible for the hospitalization of children in Sousse area, Tunisia. PLoS One 2017; 12:e0188325. [PMID: 29149199 PMCID: PMC5693464 DOI: 10.1371/journal.pone.0188325] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/03/2017] [Indexed: 12/28/2022] Open
Abstract
This study aimed to identify a broad spectrum of respiratory pathogens from hospitalized and not-preselected children with acute respiratory tract infections in the Farhat Hached University-hospital of Sousse, Tunisia. Between September 2013 and December 2014, samples from 372 children aged between 1 month and 5 years were collected, and tested using multiplex real-time RT-PCR by a commercial assay for 21 respiratory pathogens. In addition, samples were screened for the presence of Streptococcus pneumoniae 16S rDNA using real-time PCR. The viral distribution and its association with clinical symptoms were statistically analyzed. Viral pathogens were detected in 342 (91.93%) of the samples of which 28.76% were single positive and 63.17% had multiple infections. The most frequent detected viruses were rhinovirus (55.64%), respiratory syncytial virus A/B (33.06%), adenovirus (25.00%), coronavirus NL63, HKU1, OC43, and 229E (21.50%), and metapneumovirus A/B (16.12%). Children in the youngest age group (1–3 months) exhibited the highest frequencies of infection. Related to their frequency of detection, RSV A/B was the most associated pathogen with patient’s demographic situation and clinical manifestations (p<0.05). Parainfluenza virus 1–4 and parechovirus were found to increase the risk of death (p<0.05). Adenovirus was statistically associated to the manifestation of gastroenteritis (p = 0.004). Rhinovirus infection increases the duration of oxygen support (p = 0.042). Coronavirus group was statistically associated with the manifestation of bronchiolitis (p = 0.009) and laryngitis (p = 0.017). Streptococcus pneumoniae DNA was detected in 143 (38.44%) of tested samples. However, only 53 samples had a concentration of C-reactive protein from equal to higher than 20 milligrams per liter, and 6 of them were single positive for Streptocuccus pneumoniae. This study confirms the high incidence of respiratory viruses in children hospitalized for acute respiratory tract infections in the Sousse area, Tunisia.
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Affiliation(s)
- Ines Brini
- Laboratory of Microbiology and Immunology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
- Innsbruck Medical University, Innsbruck, Austria
- * E-mail: (IB); (HS)
| | - Aida Guerrero
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Naila Hannachi
- Laboratory of Microbiology and Immunology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Jihene Bouguila
- Pediatric Service, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Dorothea Orth-Höller
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
| | - Amira Bouhlel
- Pediatric Service, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Lamia Boughamoura
- Pediatric Service, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | | | - Wegene Borena
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Britta Schiela
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Dorothee Von Laer
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
| | - Jalel Boukadida
- Laboratory of Microbiology and Immunology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia
| | - Heribert Stoiber
- Division of Virology, Innsbruck Medical University, Innsbruck, Austria
- * E-mail: (IB); (HS)
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The Pneumococcal Serotype 15C Capsule Is Partially O-Acetylated and Allows for Limited Evasion of 23-Valent Pneumococcal Polysaccharide Vaccine-Elicited Anti-Serotype 15B Antibodies. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017. [PMID: 28637806 DOI: 10.1128/cvi.00099-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
As a species, Streptococcus pneumoniae (the pneumococcus) utilizes a diverse array of capsular polysaccharides to evade the host. In contrast to large variations in sugar composition and linkage formation, O-acetylation is a subtle capsular modification that nonetheless has a large impact on capsular shielding and recognition of the capsule by vaccine-elicited antibodies. Serotype 15B, which is included in the 23-valent pneumococcal polysaccharide vaccine (PPV23), carries the putative O-acetyltransferase gene wciZ The coding sequence of wciZ contains eight consecutive TA repeats [(TA)8]. Replication slippage is thought to result in the addition or loss of TA repeats, subsequently causing frameshift and truncation of WciZ to yield a nonacetylated serotype, 15C. Using sensitive serological tools, we show that serotype 15C isolates whose wciZ contains seven or nine TA repeats retain partial O-acetylation, while serotype 15C isolates whose wciZ contains six TA repeats have barely detectable O-acetylation. We confirmed by inhibition enzyme-linked immunosorbent assay that (TA)7 serotype 15C is ∼0.1% as acetylated as serotype 15B, while serotype 15X is nonacetylated. To eliminate the impact of genetic background, we created isogenic serotype 15B, (TA)7 serotype 15C, and 15BΔwciZ (15X) strains and found that reduction or absence of WciZ-mediated O-acetylation did not affect capsular shielding from phagocytes, biofilm formation, adhesion to nasopharyngeal cells, desiccation tolerance, or murine colonization. Sera from PPV23-immunized persons opsonized serotype 15B significantly but only slightly better than serotypes 15C and 15X; thus, PPV23 may not result in expansion of serotype 15C.
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Andrade DC, Borges IC, Bouzas ML, Oliveira JR, Fukutani KF, Queiroz AT, de Oliveira CI, Barral A, Van Weyenbergh J, Nascimento-Carvalho C. 10-valent pneumococcal conjugate vaccine (PCV10) decreases metabolic activity but not nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae. Vaccine 2017; 35:4105-4111. [DOI: 10.1016/j.vaccine.2017.06.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/09/2017] [Accepted: 06/19/2017] [Indexed: 01/30/2023]
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