A Cross-Sectional Observational Study of Pneumococcal Carriage in Children, Their Parents, and Older Adults Following the Introduction of the 7-Valent Pneumococcal Conjugate Vaccine

Hamaluba, Mainga; Kandasamy, Rama; Ndimah, Susan; Morton, Richard E.; Caccamo, Marisa; Robinson, Hannah; Kelly, Sarah; Field, Aimee; Norman, Lily; Plested, Emma; Thompson, Ben; Zafar, Azhar; Kerridge, Simon; Lazarus, Rajeka; John, Tessa M.; Holmes, Jane; Fenlon, Shannon N.; Gould, Katherine A.; Waight, Pauline; Hinds, Jason; Crook, Derrick W.; Snape, Matthew D.; Pollard, Andrew J.

doi:10.1097/md.0000000000000335

Cited by 28 publications

(28 citation statements)

References 32 publications

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“…This vaccine contained the CPS of seven highly virulent serotypes of S. pneumoniae covalently conjugated to the carrier protein, non-toxic diphtheria toxin mutant CRM197 (Table 1). 18 While this conjugate vaccine showed evidence of greater protection in children and herd effect among the population, 19 the effectiveness in adults was not well studied. 5 In 2010, a new conjugate vaccine was released in the United States, Prevnar® PCV13.…”

Section: Characteristics Of the Bacteriummentioning

confidence: 99%

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Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them

Wantuch

Avci

2018

Human Vaccines & Immunotherapeutics

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Streptococcus pneumoniae is a major human bacterial pathogen responsible for millions of deaths each year and significantly more illnesses worldwide. With over 90 different serotypes, providing effective vaccine programs has been a continuing challenge. Since 1983, the world has been introduced to four different pneumococcal vaccines (PPSV23, PCV7, PCV10, and PCV13) each with their own complications and successes. Since vaccination programs began, a decrease in the overall rate of pneumococcal pneumonia and associated diseases has been observed, notably in higher risk populations. However, with a decrease in incidence of vaccine type pneumococcal serotypes, increases in non-vaccine serotypes of the bacteria have been observed along with serotype switching. Additionally, a rise in antibiotic resistant strains of S. pneumoniae is noted. Here we discuss both the positive and negative clinical manifestations of pneumonia vaccine programs and discuss the challenges in pneumococcal vaccine design.

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Section: Characteristics Of the Bacteriummentioning

confidence: 99%

“…It is estimated that worldwide pneumococcal disease causes 11% of all deaths in children less than five. 19 A study looking at the effects of the PCV7 vaccine noted the risk in this group and the importance of implementing the PCV7 vaccine as PPSV23 was not considered effective in children. 20 …”

Section: Characteristics Of the Bacteriummentioning

confidence: 99%

Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them

Wantuch

Avci

2018

Human Vaccines & Immunotherapeutics

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“…While vaccination of elderly persons has been considered [ 4 ], it has been assumed that immunisation of infants alone may have already resulted in herd immunity, protecting adults against disease caused by vaccine serotypes (VTs) [ 6 ]. However, studies investigating the herd effects of PCVs on serotype carriage in adults are limited and even more rare when elderly are considered [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…pneumoniae from culture very difficult [ 20 , 21 ]. In the scarce recent studies among elderly, the use of swabs usually resulted in carriage being detected in less than 5% of individuals [ 8 , 9 , 22 – 25 ]. Low rates of nasopharyngeal pneumococcal carriage argue against significant benefits of epidemiological surveillances on colonisation in this age group [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Carriage of Streptococcus pneumoniae in Aged Adults with Influenza-Like-Illness

et al. 2015

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Incidence of pneumococcal disease is disproportionally high in infants and elderly. Nasopharyngeal colonisation by Streptococcus pneumoniae is considered a prerequisite for disease but unlike in children, carriage in elderly is rarely detected. Here, we tested for S. pneumoniae in nasopharyngeal and saliva samples collected from community-dwelling elderly with influenza-like-illness (ILI). Trans-nasal nasopharyngeal, trans-oral nasopharyngeal and saliva samples (n = 270 per sample type) were collected during winter/spring 2011/2012 from 135 persons aged 60–89 at onset of ILI and 7–9 weeks later following recovery. After samples were tested for pneumococci by conventional culture, all plate growth was collected. DNA extracted from plate harvests was tested by quantitative-PCRs (qPCR) specific for S. pneumoniae and serotypes included in the 13-valent pneumococcal conjugated vaccine (PCV13). Pneumococci were cultured from 14 of 135 (10%) elderly with none of the sampled niches showing superiority in carriage detection. With 76/270 (28%) saliva, 31/270 (11%) trans-oral and 13/270 (5%) trans-nasal samples positive by qPCR, saliva was superior to nasopharyngeal swabs (p<0.001) in qPCR-based carriage detection. Overall, from all methods used in the study, 65 of 135 (48%) elderly carried pneumococci at least once and 26 (19%) at both study time points. The difference between carriage prevalence at ILI (n = 49 or 36%) versus recovery (n = 42 or 31%) was not significant (p = 0.38). At least 23 of 91 (25%) carriage events in 19 of 65 (29%) carriers were associated with PCV13-serotypes. We detected a large reservoir of pneumococci in saliva of elderly, with PCV13-serotype distribution closely resembling the contemporary carriage of serotypes reported in the Netherlands for PCV-vaccinated infants.

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“…Although colonization within the nasal passage often is asymptomatic, access to the airways can result in pneumonia, with further dissemination causing invasive pneumococcal disease (i.e., otitis media, bacteremia, and meningitis) (1,2). Previous studies analyzing the nasopharyngeal culture of 1,704 samples, including children and adults from the same population, revealed that 53% of children carried S. pneumoniae within the nasopharyngeal tract as opposed to only 4 to 11% that were adult carriers (3)(4)(5). Furthermore, S. pneumoniae carriage rates positively correlate with age in young children and then begin to drop in adults (3,6,7).…”

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Streptococcus pneumoniae Colonization Disrupts the Microbial Community within the Upper Respiratory Tract of Aging Mice

et al. 2016

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f Nasopharyngeal colonization by the Gram-positive bacterium Streptococcus pneumoniae is a prerequisite for pneumonia and invasive pneumococcal diseases. Colonization is asymptomatic, involving dynamic and complex interplay between commensals, the host immune system, and environmental factors. The elderly are at an increased risk of developing pneumonia, which might be due to changes in the respiratory microbiota that would impact bacterial colonization and persistence within this niche. We hypothesized that the composition of the upper respiratory tract (URT) microbiota changes with age and subsequently can contribute to sustained colonization and inefficient clearance of S. pneumoniae. To test this, we used a mouse model of pneumococcal colonization to compare the composition of the URT microbiota in young, middle-aged, and old mice in the naive state and during the course of colonization using nasal pharyngeal washes. Sequencing of variable region 3 (V3) of the 16S rRNA gene was used to identify changes occurring with age and throughout the course of S. pneumoniae colonization. We discovered that age affects the composition of the URT microbiota and that colonization with S. pneumoniae is more disruptive of preexisting communities in older mice. We have further shown that host-pathogen interactions following S. pneumoniae colonization can impact the populations of resident microbes, including Staphylococcus and Haemophilus. Together, our findings indicate alterations to the URT microbiota could be detrimental to the elderly, resulting in increased colonization of S. pneumoniae and decreased efficiency in its clearance.

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A Cross-Sectional Observational Study of Pneumococcal Carriage in Children, Their Parents, and Older Adults Following the Introduction of the 7-Valent Pneumococcal Conjugate Vaccine

Abstract: Supplemental Digital Content is available in the text

Cited by 28 publications

References 32 publications

Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them

Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them

Carriage of Streptococcus pneumoniae in Aged Adults with Influenza-Like-Illness

Streptococcus pneumoniae Colonization Disrupts the Microbial Community within the Upper Respiratory Tract of Aging Mice

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