Bacterial nasopharyngeal colonisation in children in South Africa before and during the COVID-19 pandemic: an observational study

Olwagen, Courtney P; Downs, Sarah L; Izu, Alane; Tharasimbi, Lebohang; Van Der Merwe, Lara; Nunes, Marta C; Madhi, Shabir A

doi:10.1016/s2666-5247(23)00260-4

Cited by 7 publications

(1 citation statement)

References 20 publications

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“…Similar declines in bacterial disease during early waves of COVID-19 have been observed in the context of sentinel community-acquired infections in New Zealand (Duffy et al, 2021), IPDs in Taiwan (Chien et al, 2021) and Hong Kong (Teng et al, 2022), and lower respiratory tract infections in China (Chen et al, 2021). Yet, surprisingly, a growing number of studies have reported mostly stable pneumococcal carriage throughout the COVID-19 pandemic containment, including among infants in Belgium (Willen et al, 2022), children in Vietnam (Nation et al, 2023), Serbia (Petrović et al, 2022), France (Rybak et al, 2022), South Africa (Olwagen et al, 2023), and Israel (Dagan et al, 2023), adults in Connecticut (Wyllie et al, 2023), and households in Seattle (Bennett et al, 2023). In contrast, a study conducted in Denmark reported a decrease in pneumococcal carriage among older adults during the COVID-19 lockdown (Tinggaard et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

Kovacevic

Smith

Rahbé

et al. 2022

Preprint

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COVID-19 pandemic responses have dramatically modified the global ecological and epidemiological landscape of many infectious diseases. However, the pandemic’s impacts on antimicrobial resistance (AMR) are currently poorly understood and lack data. While surges in COVID-19 cases during the first wave of the pandemic may have exacerbated AMR, decreases in antibiotic use may have had the opposite effect. To disentangle how pandemic impacts such as lockdowns and modified antibiotic prescribing may affect AMR, we developed a mathematical model formalizing simultaneous transmission of SARS-CoV-2 and colonization with a bacterial pathogen across six pandemic scenarios. We used simulation to assess the effect of each scenario on the bacterial carriage prevalence, antibiotic resistance rate, and the invasive bacterial disease (IBD) incidence, using parameters based on the commensal community bacterium Streptococcus pneumoniae. Pandemic scenarios without community-wide lockdowns all resulted in a decrease in carriage prevalence of antibiotic-sensitive bacteria and an increase in the prevalence of antibiotic-resistant bacteria, while the addition of a population-wide lockdown resulted in a large reduction in colonization prevalence and IBD incidence for both strains (>70%). This translated to an increase in the antibiotic resistance rate across all scenarios to varying degrees, with lingering effects after the cessation of COVID-19 response measures. In the absence of lockdown, a population-wide surge in antibiotic prescribing coincident with the peak in SARS-CoV-2 infection resulted in the greatest increases in resistance rate (23%) and resistant IBD incidence (6%). Within-host interactions, SARS-CoV-2 variants, and population immunity are found to further drive the magnitude of pandemic impacts on resistant IBD incidence. Sensitivity analyses suggest that the extent of such impacts likely varies across different bacterial species. Although real-life scenarios are significantly more complicated, our findings suggest that COVID-19 pandemic responses may significantly impact antibiotic resistance in the community and support the need for monitoring resistance during pandemic waves.

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Section: Introductionmentioning

confidence: 99%

Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

Kovacevic

Smith

Rahbé

et al. 2022

Preprint

View full text Add to dashboard Cite

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Haemophilus influenzae and pneumococci: Co‐colonization, interactions, cooperation and competition

McMahon,

Ware,

Grimwood

et al. 2024

Pediatric Pulmonology

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Nontypeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae (pneumococcus) are pathobionts that share common environmental niches within the upper respiratory tract. They can form part of the resident upper airway microbiota, but under certain environmental circumstances become pathogenic and induce disease. In children, both organisms have a considerable impact on the healthcare system, commonly causing acute otitis media and pneumonia. They are also associated with chronic biofilm‐mediated respiratory infections, such as persistent middle ear effusions and chronic suppurative otitis media, and in the lower airways with protracted bacterial bronchitis and bronchiectasis. Consequently, both organisms are responsible for large numbers of antibiotic prescriptions and substantial healthcare costs. The complex relationship between NTHi and pneumococcal co‐interaction during colonization, infection and biofilm formation is poorly understood and a greater understanding is needed to facilitate development of future therapies, and novel interventions and prevention strategies. Co‐infections with both bacteria can result in more severe disease, with disease severity likely mediated by their ability to cooperate in some in vivo niches. However, this relationship is not always straightforward, as under certain conditions, these two bacteria compete rather than cooperate. Current opinion supports developing a vaccine targeting NTHi strains, as well as a combined vaccine targeting both NTHi and pneumococci to decrease the respiratory disease burden in young children. This review summarizes our current knowledge of the interactions between NTHi and pneumococci and speculates on the future directions of research to understand how these bacteria co‐exist and how to better prevent and treat NTHi and pneumococcal infection.

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Single priming and a booster dose of 10-valent and 13-valent pneumococcal conjugate vaccine (PCV) maintains suppression of vaccine serotype colonization in South African children at 3, 4, and 5 years of age: a single-centre, open-labelled, randomized trial

Olwagen,

Izu,

Van der Merwe

et al. 2024

Expert Review of Vaccines

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Bacterial nasopharyngeal colonisation in children in South Africa before and during the COVID-19 pandemic: an observational study

Cited by 7 publications

References 20 publications

Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

Revealing the drivers of antibiotic resistance trends inStreptococcus pneumoniaeamidst the 2020 COVID-19 pandemic: Insights from mathematical modeling

Haemophilus influenzae and pneumococci: Co‐colonization, interactions, cooperation and competition

Single priming and a booster dose of 10-valent and 13-valent pneumococcal conjugate vaccine (PCV) maintains suppression of vaccine serotype colonization in South African children at 3, 4, and 5 years of age: a single-centre, open-labelled, randomized trial

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