Absence of<i>Streptococcus pneumoniae</i>in pharyngeal swabs of geriatric inpatients

Jomrich, Nina Isabel; Kellner, S; Djukic, Marija; Eiffert, Helmut; Nau, Roland

doi:10.3109/00365548.2015.1007476

Cited by 4 publications

(5 citation statements)

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“…With a post-serotyping prevalence of 0.8%, we found a quite lower pneumococcal carriage rate than expected [ 13 , 20 , 21 ]. However, our study confirmed the results of recent studies in seniors [ 22 – 24 ], nursing home residents [ 23 ] and geriatric patients [ 25 ] revealing carriage rates between 0% and 2.3%. To improve detection of pneumococcal carriage, we used nasopharyngeal and oropharyngeal swabs as previously suggested [ 26 ] taken by a specifically trained study nurse [ 19 ].…”

Section: Discussionsupporting

confidence: 92%

Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment

et al. 2018

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ObjectiveFrom April 2013 to February 2014 we performed a multicentre prospective cross-sectional study in 541 German nursing home residents. We determined pharyngeal carriage of Streptococcus pneumoniae (primary objective) and other bacteria (secondary objective) in naso- and oropharyngeal swabs by culture-based standard procedures and explored the influence of multimorbidity and functional status on bacterial carriage.MethodsSocio-demographic data, vaccination status, multimorbidity, nutrition and functional status defined by Comprehensive Geriatric Assessment were evaluated. We estimated carriage rates with 95% confidence intervals (CI) and explored potential risk factors by logistic regression analysis.ResultsPneumococcal post-serotyping carriage rate was 0.8% (95%CI 0.2–1.9%; 4/526). Serotyping revealed serotypes 4, 7F, 23B and 23F and S. pseudopneumoniae in two other cases. Odds of carriage were higher in men (Odds ratio OR 5.3 (95%CI 0.9–29.4)), in malnourished residents (OR 4.6 (0.8–25.7)), residents living in shared rooms (OR 3.0 (0.5–16.5)) or having contact with schoolchildren (OR 2.0 (0.2–17.6)). The most frequent pathogen was Staphylococcus aureus (prevalence 29.5% (25.6–33.6%)) with meticillin-resistant Staphylococcus aureus prevalence of 1.1%. Gram-negative bacteria (GNB) were found in 22.5% (19.0–26.3%) with a prevalence of extended-spectrum beta lactamase (ESBL) producing bacteria of 0.8%. Odds of S. aureus carriage were higher for immobility (OR 1.84 (1.15–2.93)) and cognitive impairment (OR 1.54 (0.98–2.40)). Odds of GNB carriage were higher in residents with more severe comorbidity (OR 1.13 (1.00–1.28)) and malnutrition (OR 1.54 (0.81–2.91)).ConclusionsGiven the observed data, at least long-term carriage of S. pneumoniae in nursing home residents seems to be rare and rather unlikely to cause nursing home acquired pneumonia. The low rate of colonization with multi drug resistant (MDR) bacteria confirms that nursing home residency is not a risk factor for MDR pneumonia in Germany. For individual risk assessment in this susceptible population, immobility and malnutrition should be considered as signs of functional impairment as well as comorbidity.

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Section: Discussionsupporting

confidence: 92%

Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment

et al. 2018

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“…In fact, colonization rates strongly depend on sampling site, preanalytic conditions, processing methods (cultural or molecular detection by PCR) and age. Hence, colonization rates in elderly individuals can range from 0% [49] to 22% [19]. There is no clear evidence from the data available which sampling site yields optimal detection rates in adults.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic carriage of Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, Group A Streptococcus and Staphylococcus aureus among adults aged 65 years and older

et al. 2019

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ObjectiveThe aim of this study was to determine the prevalence of Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, group A Streptococcus (GAS), and Staphylococcus aureus in asymptomatic elderly people and to unravel risk factors leading to colonization.MethodsA multi-centre cross-sectional study was conducted including 677 asymptomatic adults aged 65 years or more, living at home or in nursing homes. Study areas were Greater Aachen (North-Rhine-Westphalia) and Wuerzburg (Bavaria), both regions with medium to high population density. Nasal and oropharyngeal swabs as well as questionnaires were collected from October 2012 to May 2013. Statistical analysis included multiple logistic regression models.ResultsThe carriage rate was 1.9% ([95%CI: 1.0–3.3%]; 13/677) for H. influenzae, 0.3% ([95%CI: 0–1.1%]; 2/677) for N. meningitidis and 0% ([95% CI: 0–0.5%]; 0/677) for S. pneumoniae and GAS. Staphylococcus aureus was harboured by 28.5% of the individuals ([95% CI: 25.1–32.1%]; 193/677) and 0.7% ([95% CI: 0.2–1.7%]; 5/677) were positive for methicillin-resistant S. aureus. Among elderly community-dwellers colonization with S. aureus was significantly associated with higher educational level (adjusted OR: 1.905 [95% CI: 1.248–2.908]; p = 0.003). Among nursing home residents colonization was associated with being married (adjusted OR: 3.367 [1.502–7.546]; p = 0.003).ConclusionThe prevalence of N. meningitidis, H. influenzae, S. pneumoniae and GAS was low among older people in Germany. The S. aureus rate was expectedly high, while MRSA was found in less than 1% of the individuals.

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“…According to our study results, PCV13 covers 20% of the serotypes isolated. In similar studies from Europe, the coverage of PCV13 varied between 9.1% and 51.4% (16,19,20,22,23). In a recent study from Japan, 18.2% of the participants carried a pneumococcal serotype included in PCV13 (24).…”

Section: Discussionmentioning

confidence: 95%

“…Molecular methods to investigate NP pneumococcal carriage have been recently developed. Recent studies report that conventional culture methods underestimate pneumococcal carriage prevalence and molecular methods are superior to conventional methods in detecting pneumococcal carriage ( 19 , 20 , 22 , 23 , 24 ). Because of the lack of specific anti-sera for further serotyping in pneumotest plus kit, the serotypes of serogroup 10, 11, 15, 17, and 33 could not be determined and the exact vaccine coverage of PPSV23 could not be found.…”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal Carriage and Serotype Distribution of Streptococcus pneumoniae in Elderly: A Cross-sectional Study in Turkey

Çelİk¹,

Abdullayeva²,

Çavuş³

2022

Infect Dis Clin Microbiol

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Objective:The incidence and mortality of invasive pneumococcal disease are much higher in people over 65 years compared to the general population. The incidence of the disease and the distribution of serotypes changed with the spread of childhood conjugate pneumococcal vaccines and the use of vaccines in the adult age group. Nasopharyngeal carriage is an important stage in the disease pathogenesis. In this study, we aimed to determine the pneumococcal carriage prevalence and serotype distribution in adults aged ≥ 65 years living in a nursing home. Materials and Methods:The nasopharyngeal swabs were taken from ≥ 65 years old people living in Narlıdere Nursing Home. The specimens were cultured and pneumococci were isolated according to colony appearance, optochin sensitivity and solubility in bile salts. Pneumococcal serotypes were identified using the capsule swelling reaction.Results: Pneumococcus was isolated in 10 of 341 subjects and the pneumococcal carriage prevalence was 2.9%. Advanced age, immunocompromised status and chronic renal failure were associated with pneumococcal carriage. In multivariate model, having immunocompromised status was significantly associated with carriage. Serotypes/serogroups of pneumococci were 7F, 23F, 10, 11, 15. 17, 20 and 33. The 13 valent conjugated pneumococcal vaccine serotype carriage prevalence was 0.6%. Conclusion:Although pneumococcal colonization in older people is uncommon, most of the isolated serotypes are not PCV13 serotypes. The monitoring of pneumococcal serotypes can offer useful information about the circulation of this pathogen among older people and the potential protective effect of pneumococcal vaccines.

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Absence ofStreptococcus pneumoniaein pharyngeal swabs of geriatric inpatients

Cited by 4 publications

References 19 publications

Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment

Naso- and oropharyngeal bacterial carriage in nursing home residents: Impact of multimorbidity and functional impairment

Asymptomatic carriage of Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, Group A Streptococcus and Staphylococcus aureus among adults aged 65 years and older

Nasopharyngeal Carriage and Serotype Distribution of Streptococcus pneumoniae in Elderly: A Cross-sectional Study in Turkey

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