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Kang HM, Kang JH. Effects of nasopharyngeal microbiota in respiratory infections and allergies. Clin Exp Pediatr 2021; 64:543-551. [PMID: 33872488 PMCID: PMC8566799 DOI: 10.3345/cep.2020.01452] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/02/2021] [Indexed: 11/27/2022] Open
Abstract
The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. The nasopharyngeal acquisition of pneumococcus, which exists as a pathobiont in the nasal cavity, is the initial step in virtually all pneumococcal diseases. Although the factors influencing nasal colonization and elimination are not fully understood, the adhesion of opportunistic pathogens to nasopharyngeal mucosa receptors and the eliciting of immune responses in the host are implicated in addition to bacterial microbiota properties and colonization resistance dynamics. Probiotics or synbiotic interventions may show promising and effective roles in the adjunctive treatment of dysbiosis; however, more studies are needed to characterize how these interventions can be applied in clinical practice in the future.
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Affiliation(s)
- Hyun Mi Kang
- Division of Pediatric Infectious Diseases, Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Division of Pediatric Infectious Diseases, Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lee J, Kim KH, Jo DS, Ma SH, Kim JH, Kim CS, Kim HM, Kang JH. A longitudinal hospital-based epidemiology study to assess acute otitis media incidence and nasopharyngeal carriage in Korean children up to 24 months. Hum Vaccin Immunother 2020; 16:3090-3097. [PMID: 32330397 DOI: 10.1080/21645515.2020.1748978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
This study was conducted to assess the nasopharyngeal (NP) carriage and acute otitis media (AOM) occurrence in Korean children who received pneumococcal conjugate vaccines (PCVs). The longitudinal study was conducted through four consecutive visits. At each visit, NP aspirates were obtained and subjects were asked to visit if AOM occurred. A total of 305 subjects were enrolled and received PCV13 (n = 182) or PCV10 (n = 123). In the PCV13 group, the NP carriage of Streptococcus pneumoniae at each visit was 2.7%, 14.8%, 18.7%, and 15.9%, respectively. Non-typeable Haemophilus influenzae (NTHi) was 3.3%, 2.7%, 2.7%, and 5.5%, and that of Moraxella catarrhalis was 1.1%, 9.3%, 4.9%, and 0.5%. In the PCV10 group, the NP carriage of S. pneumoniae at each visit was 3.3%, 7.3%, 6.5%, and 4.1%, respectively. That of NTHi was 2.4%, 4.1%, 1.6%, and 0.8%, and that of M. catarrhalis was 4.1%, 0.8%, 0.8%, and 0.0%. AOM occurrence in the PCV13 group observed after the primary dose and before booster dose was 20.9%, occurrence after booster dose was 11.0%, and the incidence of two or more AOM was 11.0%. In the PCV10 group, AOM occurrence was 9.8%, 7.3%, respectively, and the incidence of two or more AOM was 2.4%. The predominant S. pneumoniae isolated were non-vaccine type (10A, 15A, and 15B). In this study, AOM occurrence was lower in the PCV10 group than in the PCV13 group. This seems to be related to ecological changes that lead to differences in NP carriage, especially S. pneumoniae and NTHi.
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Affiliation(s)
- Jin Lee
- Department of Pediatrics, Hanil General Hospital , Seoul, Republic of Korea
| | - Ki Hwan Kim
- Department of Pediatrics, Incheon St. Mary's Hospital, The Catholic University of Korea , Incheon, Republic of Korea
| | - Dae Sun Jo
- Department of Pediatrics, Chonbuk National University Children's Hospital , Jeonju, Republic of Korea
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital , Changwon, Republic of Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, St. Vincent's Hospital, the Catholic University of Korea , Suwon, Republic of Korea
| | - Chun Soo Kim
- Department of Pediatrics, Dongsan Medical Center, Keimyung University School of Medicine , Daegu, Republic of Korea
| | - Hwang Min Kim
- Department of Pediatrics, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine , Wonju, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea , Seoul, Republic of Korea
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3
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Tin Tin Htar M, Sings HL, Syrochkina M, Taysi B, Hilton B, Schmitt HJ, Gessner BD, Jodar L. The impact of pneumococcal conjugate vaccines on serotype 19A nasopharyngeal carriage. Expert Rev Vaccines 2019; 18:1243-1270. [DOI: 10.1080/14760584.2019.1675521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | - Heather L. Sings
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Maria Syrochkina
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Moscow, Russia
| | - Bulent Taysi
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Istanbul, Turkey
| | - Betsy Hilton
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Heinz-Josef Schmitt
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Bradford D. Gessner
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Luis Jodar
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
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Dilagui I, Moussair F, Loqman S, Diawara I, Zerouali K, Belabbes H, Zouhair S, Bourouss M, Bouskraoui M, Soraa N. Streptococcus pneumoniae carriage among febrile children at the time of PCV-10 immunization in pediatric emergencies at Mohammed VI University Hospital Centre in Marrakesh (Morocco). Arch Pediatr 2019; 26:453-458. [DOI: 10.1016/j.arcped.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/17/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
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Manenzhe RI, Moodley C, Abdulgader SM, Robberts FJL, Zar HJ, Nicol MP, Dube FS. Nasopharyngeal Carriage of Antimicrobial-Resistant Pneumococci in an Intensively Sampled South African Birth Cohort. Front Microbiol 2019; 10:610. [PMID: 30972052 PMCID: PMC6446970 DOI: 10.3389/fmicb.2019.00610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/11/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction: Nasopharyngeal (NP) colonization by Streptococcus pneumoniae (pneumococcus) precedes the development of respiratory tract infection. Colonization by antimicrobial-resistant pneumococci, especially in infants, is a major public health concern. We longitudinally investigated antimicrobial-resistance amongst pneumococci colonizing the nasopharynx of South African infants immunized with the 13-valent pneumococcal conjugate vaccine (PCV13). Methods: NP swabs were collected every second week from birth through the first year of life from 137 infants. Pneumococci were identified and serotyped using conventional microbiological techniques, and their antibiotic susceptibility profiles determined by disk diffusion and E-test. Results: All infants were immunized with 3 doses of PCV13. 1520 pneumococci (760 non-repeat) isolates were recovered from 137 infants; including non-typeable (n = 99), PCV13 (n = 133) and non-PCV13 serotypes (n = 528). The prevalence of penicillin, erythromycin, and cotrimoxazole non-susceptibility was 19% (95% CI 17-22%) (3% fully resistant), 18% (95% CI 15-21%) (14% fully resistant), and 45% (95% CI 42-49%) (36% fully resistant), respectively. The predominant penicillin-non-susceptible serotypes included 19A, 19F, 15B/15C, 15A, and 21, while susceptible serotypes included 23A, 34, and 17A. Multidrug-resistance (MDR) was observed in 9% (95% CI 7-11%) of the isolates. PCV13 serotypes were more likely to be non-susceptible, compared to non-PCV13 serotypes, to penicillin (26% vs. 16%, p = 0.007), erythromycin (23% vs. 15%, p = 0.027) and cotrimoxazole (62% vs. 41%, p < 0.001). Non-susceptibility to penicillin, erythromycin, and cotrimoxazole remained relatively constant through the first year of life (X 2 test for trend: p = 0.184, p = 0.171, and p = 0.572, respectively). Overall, penicillin or erythromycin-non-susceptible pneumococci were carried for a shorter duration than susceptible pneumococci [penicillin (mean days, 18 vs. 21, p = 0.013) and erythromycin (mean days, 18 vs. 21, p = 0.035)]. Within individual infants carrying the same serotype longitudinally, changes in antibiotic susceptibility were observed over time in 45% (61/137) of infants and these changes were predominantly for penicillin (76%, 79/104). Conclusion: Prevalence of NP carriage with antibiotic-non-susceptible pneumococci was relatively constant throughout the first year of life. PCV13 serotypes were more commonly non-susceptible to penicillin, erythromycin, and cotrimoxazole. Penicillin or erythromycin-non-susceptible pneumococci were carried for a shorter duration than penicillin or erythromycin-susceptible pneumococci.
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Affiliation(s)
- Rendani I. Manenzhe
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Clinton Moodley
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Shima M. Abdulgader
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - F. J. Lourens Robberts
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Mark P. Nicol
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Felix S. Dube
- Division of Medical Microbiology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
- Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa
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Wang L, Fu J, Liang Z, Chen J. Prevalence and serotype distribution of nasopharyngeal carriage of Streptococcus pneumoniae in China: a meta-analysis. BMC Infect Dis 2017; 17:765. [PMID: 29237402 PMCID: PMC5729489 DOI: 10.1186/s12879-017-2816-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 11/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To explore the overall prevalence and serotype distribution of nasopharyngeal carriage of Streptococcus pneumoniae(S. pneumoniae) among healthy children. METHODS A search for pneumococcal nasopharyngeal carriage studies including children published up to July 31th, 2016 was conducted to describe carriage in China. The review also describes antibiotic resistance in and serotypes of S. pneumoniae and assesses the impact of vaccination on carriage in this region. Summary measures for overall prevalence, antibiotic resistance, and serotype distributions extracted from the analyzed data were determined with 95% confidence intervals (CIs) using random-effects models. Heterogeneity was assessed using I 2 test statistics. RESULTS Thirty-seven studies were included in this review, and the majority of studies (64.9%) were located in the pre-introduction period of 7-valent pneumococcal conjugate vaccine (PCV7) in China. The pooled prevalence of S. pneumoniae nasopharyngeal carriage was 21.4% (95% CI: 18.3-24.4%). Carriage was highest in children attending kindergartens [24.5%, (19.7-29.3%)] and decreased with increasing age. Before the introduction of PCV7 into China, the prevalence of S. pneumoniae nasopharyngeal carriage was 25.8% (20.7-30.9%), the pooled carriage of S. pneumoniae sharply dropped into the 14.1% (11.3-16.9%) by PCV7 vaccination period (P < 0.001). Before the pneumococcal conjugate vaccine (PCV) was introduced in China, the penicillin resistance rate in S. pneumoniae isolated from healthy children was 31.9% (21.2-42.6%); however, this rate sharply decreased after the introduction of PCV7 in China [21.6%, (7.4-35.9%)], and the difference between the rates during these two time periods was statistically significant (P value <0.05). Serotypes 19F, 6A and 23F were the most commonly isolated. Meta-analysis of data from young children showed a pooled rate estimate of 46.6% (38.8-54.4%) for PCV7 vaccine coverage and 66.2% (58.6-73.8%) for PCV13 vaccine coverage. CONCLUSIONS The prevalence of nasopharyngeal carriage among children was high in China. PCV7 immunization was found to be associated with reduction of nasopharyngeal colonization of S. pneumoniae. Conjugate vaccination coverage was slightly affected by the introduction of PCV7 into China because of low vaccination rate. The government should implement timely adjusted conjugate vaccination strategies based on our findings.
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Affiliation(s)
- Lin Wang
- Department of Science and Education, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi China
| | - Jinjian Fu
- Department of Laboratory, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi China
| | - Zhuoxin Liang
- Department of Pediatrics, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi China
| | - Jichang Chen
- Department of Neonatology, Liuzhou Municipal Maternity and Child Healthcare Hospital, Liuzhou, Guangxi China
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Lindstrand A, Galanis I, Darenberg J, Morfeldt E, Naucler P, Blennow M, Alfvén T, Henriques-Normark B, Örtqvist Å. Unaltered pneumococcal carriage prevalence due to expansion of non-vaccine types of low invasive potential 8years after vaccine introduction in Stockholm, Sweden. Vaccine 2016; 34:4565-4571. [PMID: 27473304 DOI: 10.1016/j.vaccine.2016.07.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/03/2016] [Accepted: 07/18/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the carriage prevalence, serotype distribution, and antibiotic resistance for pneumococcal carriage isolates collected 4-8years after introduction of pneumococcal conjugate vaccines (PCVs) in Stockholm, Sweden, and to identify risk factors for carriage and calculate the invasive disease potential for emerging serotypes. METHODS Nasopharyngeal aspirates were collected from 3024 children aged 0-<5years at regular visits at 23 Child Health Centers in Stockholm County in 2011-2015, and from 787 parents in 2014-2015. The invasive disease potential was calculated for serotypes using invasive disease isolates from 824 patients of all ages identified in the Stockholm County during the same time period as the carriage isolates. RESULTS A total carriage prevalence of 30% did not change during the study period. Non-vaccine types (NVT) dominated (94% by 2015) and the most common serotypes in descending order were 11A, 23B, 35F and 21. Risk factors for carriage were: age ⩾3months-<3years, having siblings, attending day-care and having travelled abroad the last 3months. Antibiotic resistance remained low. The invasive disease potential was high for NVT 8, 9N, 12F, and 22F, while low for a majority of emerging NVTs in carriage. CONCLUSION The carriage prevalence remained the same 4-8years after vaccine introduction, but serotype replacement became almost complete. A majority of emerging NVTs in carriage showed a low invasive disease potential. Carriage studies are an important complement to invasive disease surveillance to understand the full effect of PCV vaccine programs.
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Affiliation(s)
- Ann Lindstrand
- The Public Health Agency Sweden, SE-171 82, Solna, Sweden; Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Ilias Galanis
- The Public Health Agency Sweden, SE-171 82, Solna, Sweden
| | | | - Eva Morfeldt
- The Public Health Agency Sweden, SE-171 82, Solna, Sweden
| | - Pontus Naucler
- Department of Medicine, Unit of Infectious Diseases, Karolinska University Hospital, SE-171 76, Solna, Sweden
| | - Margareta Blennow
- Sachs' Children and Youth Hospital, South General Hospital, SE-118 83 Stockholm, Sweden; Department of Clinical Sciences and Education, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Tobias Alfvén
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Sachs' Children and Youth Hospital, South General Hospital, SE-118 83 Stockholm, Sweden
| | - Birgitta Henriques-Normark
- The Public Health Agency Sweden, SE-171 82, Solna, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Åke Örtqvist
- Department of Medicine, Unit of Infectious Diseases, Karolinska University Hospital, SE-171 76, Solna, Sweden; Department of Communicable Disease Control and Prevention, SE-118 83, Stockholm County Council, Sweden
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Pneumococcal carriage in young children after introduction of PCV13 in Hong Kong. Vaccine 2016; 34:3867-74. [DOI: 10.1016/j.vaccine.2016.05.047] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 11/18/2022]
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El-Nawawy AA, Hafez SF, Meheissen MA, Shahtout NM, Mohammed EE. Nasopharyngeal Carriage, Capsular and Molecular Serotyping and Antimicrobial Susceptibility of Streptococcus pneumoniae among Asymptomatic Healthy Children in Egypt. J Trop Pediatr 2015; 61:455-63. [PMID: 26428194 DOI: 10.1093/tropej/fmv060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide with increasing antimicrobial resistance. 600 randomly chosen asymptomatic healthy children aged 2-60 months attending Alexandria University Children's Hospital were evaluated for prevalence of nasopharyngeal (NP) carriage of S. pneumoniae. Prevalence of NP carriage was 29.2% (n = 175/600) Capsular serotyping was done using Quellung reaction. Vaccine covered serotypes (VST) represented 67.4% while non-vaccine serotypes (NVST) were 32.6%. The most common VST isolated were 19F (24.6%), 6B (14.3%) and 6A (10.9%). Confirmation of serotyping was performed by multiplex PCR which showed 100% concordance with the Quellung reaction. Antimicrobial susceptibility testing showed penicillin non-susceptibility of 15% (using non-meningitis penicillin MIC breakpoints) and 55% (using meningitis penicillin MIC breakpoints). Highest resistance was found in sulphamethoxazole-trimethoprim (55%), tetracyclins (49%), erythromycin (40%) and clindamycin (25%). This study revealed the epidemiological importance to evaluate regularly the prevalence, serotypes and the increasing antimicrobial resistance of S. pneumoniae in the community.
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Affiliation(s)
- Ahmed A El-Nawawy
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Soad F Hafez
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Marwa A Meheissen
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Nehal M Shahtout
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Essam E Mohammed
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
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Petraitiene S, Alasevicius T, Staceviciene I, Vaiciuniene D, Kacergius T, Usonis V. The influence of Streptococcus pneumoniae nasopharyngeal colonization on the clinical outcome of the respiratory tract infections in preschool children. BMC Infect Dis 2015; 15:403. [PMID: 26423571 PMCID: PMC4589981 DOI: 10.1186/s12879-015-1149-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 09/25/2015] [Indexed: 12/05/2022] Open
Abstract
Background Streptococcus pneumoniae (SPn) is an important pathogen causing a variety of clinical manifestations. The effects of SPn nasopharyngeal colonization on respiratory tract infections are poorly studied. We evaluated the association of SPn colonization with features of respiratory tract infections. Methods Children under the age of 6 years who visited a primary care physician because of respiratory tract infections were enrolled in the study. History was taken, children were clinically assessed by the physician, and nasopharyngeal swabs were obtained and cultured for SPn. Positive samples were serotyped. Associations of SPn colonization with clinical signs and symptoms, recovery duration, absence from day care centre, frequencies of specific diagnoses, and treatment with antimicrobials were evaluated. Results In total 900 children were enrolled. The prevalence of SPn colonization was 40.8 % (n = 367). There were minor differences between male and female subjects (199 of 492, 40.4 % vs 168 of 408, 41.2 %, p = 0.825). Children with and without siblings had similar colonization rates (145 of 334, 43.4 % vs 219 of 562, 39.0 %, p = 0.187). Clinical signs and symptoms were not associated with SPn colonization. Children colonized with SPn had longer recovery duration compared to non-colonized children (114 of 367, 31.1 % vs 98 of 533, 18.4 %, p < 0.001) and were longer absent from day care (270 of 608, 44.4 % vs 94 of 284, 33.1 %, p = 0.001). Pneumonia, sinusitis, and acute otitis media were more frequently diagnosed in children colonized with SPn. Children attending day care centres had significantly higher prevalence of SPn colonization (270 of 367, 44.4 % vs 338 of 533, 33.1 %, p = 0.001). Children with pneumonia, sinusitis and acute otitis media were more frequently treated with antimicrobials than children with other diagnoses. Conclusions SPn nasopharyngeal colonization has a negative impact on the course of respiratory tract infection, likely because of SPn being the cause of the disease or a complicating factor. It is also associated with and may be responsible for higher frequencies of bronchitis, pneumonia, acute otitis media, sinusitis and the need of antimicrobial treatment.
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Affiliation(s)
- Sigita Petraitiene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
| | - Tomas Alasevicius
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
| | - Indre Staceviciene
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
| | - Daiva Vaiciuniene
- Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
| | - Tomas Kacergius
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| | - Vytautas Usonis
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
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Choe YJ, Choi EH, Lee HJ. The changing epidemiology of childhood pneumococcal disease in Korea. Infect Chemother 2013; 45:145-58. [PMID: 24265963 PMCID: PMC3780948 DOI: 10.3947/ic.2013.45.2.145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Indexed: 11/30/2022] Open
Abstract
The wide use of antimicrobial agents and 7-valent pneumococcal conjugate vaccine (PCV7) has led to major changes in the epidemiology of childhood pneumococcal diseases. In Korea, data on the population-based incidence of childhood invasive pneumococcal diseases (IPD) are not available; however, institution-based surveillance data suggest a substantial burden of childhood IPD. Following the introduction of the PCV7 in Korea in 2003, the proportion of IPD caused by vaccine-type pneumococci has decreased, while non-PCV7 serotypes, especially serotypes 19A and 6A, whose proportions had been increasing before the introduction of the vaccine, became predominant among childhood IPD isolates. This article reviews the overall impact of PCV7 utilization and summarizes the results obtained so far. Continuous monitoring and gathering of scientific evidence for the epidemiological transition of pneumococcal carriage and IPD will be important for the management of pneumococcal infections in Korea.
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Affiliation(s)
- Young June Choe
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hoan Jong Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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