Spread of Streptococcus pneumoniae in Families. I. Carriage Rates and Distribution of Types

Hendley, J. Owen; Ma, Sande; Pm, Stewart; Jm, Gwaltney

doi:10.1093/infdis/132.1.55

Cited by 258 publications

(139 citation statements)

References 12 publications

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“…This rate is similar to that encountered in young children in other westernized countries. For example, Hendley et al (1975) encountered a rate of 38 % amongst pre-school children in Virginia in 1972. Somewhat higher rates were found by Loda et al (1975) amongst children in North Carolina 1970-4: for example, carriage rates were 47 % in children aged 1 year and 52 % in children aged 4 years; these children attended a day-care centre which may have accounted for the higher rates.…”

Section: Resultsmentioning

confidence: 99%

Pneumococcal carriage amongst children in Adelaide, South Australia

Hansman¹,

Morris²

1988

Epidemiol. Infect.

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SUMMARYAmongst 1267 healthy children 6 months to 4-5 years of age in Adelaide, the pneumococcal carriage rate from a single nasal swab sampling was 29% in the period 1980-1. Of 269 children, sampled monthly on five occasions, 91 % carried a pneumococcus on one or more occasions: 55 % carried a single type, 33 % carried two types, 2 % carried three types and 1 % carried four types; 18 % carried a pneumococcus on either 4 or 5 occasions. The commonest types encountered were types 6, 19 and 23 in that order, and these three types constituted 57 % of the total: other common types ( > 5 % of the total) were types 14, 15 and 11, and the six commonest types constituted 77 % of the total. Of these, types 6, 14, 19 and 23 commonly cause systemic disease in children; on the other hand types 11 and 15 cause disease infrequently. The number of strains showing antimicrobial drug resistance was low: on quantitative testing 0 7 % of 291 isolates examined showed relative resistance to benzylpenicillin and 07 % were resistant to tetracycline; 10-9 % of 230 isolates examined showed resistance to co-trimoxazole; dual or multiple drug resistance was not detected, and all isolates tested were susceptible to chloramphenicol, erythromycin, lincomycin and rifampicin.

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Section: Resultsmentioning

confidence: 99%

Pneumococcal carriage amongst children in Adelaide, South Australia

Hansman¹,

Morris²

1988

Epidemiol. Infect.

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“…Given that carriage prevalence is known to decrease in adulthood (10,14), the observed data led to the question of how antibody levels are maintained as exposure decreases. There are several possible explanations, however.…”

Section: Discussionmentioning

confidence: 99%

Age-Specific Immunoglobulin G (IgG) and IgA to Pneumococcal Protein Antigens in a Population in Coastal Kenya

et al. 2004

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Streptococcus pneumoniae is the primary etiological agent of community-acquired pneumonia and a major cause of meningitis and bacteremia. Three conserved pneumococcal proteins-pneumolysin, pneumococcal surface adhesin A (PsaA), and pneumococcal surface protein A (PspA)-are currently being investigated as vaccine candidates. Such protein-based vaccines, if proven effective, could provide a cheaper alternative to conjugate vaccine formulae. Few data from sub-Saharan Africa exist concerning the development of natural antibody to these antigens, however. To investigate the age-specific development of antiprotein immunoglobulin G (IgG) and IgA antibody responses, the sera of 220 persons 2 weeks to 84 years of age from coastal Kenya were assayed using enzyme-linked immunosorbent assays. IgG and IgA antibody responses to each antigen were observed in all age groups. Serum concentrations of IgG and IgA antibody responses to PspA and PdB (a recombinant toxoid derivative of pneumolysin), but not to PsaA, increased significantly with age (P < 0.001). No decline was observed in the sera of the elderly. Anti-protein IgG concentrations were only weakly correlated (0.30 < r < 0.56; P < 0.0001), as were IgA concentrations (0.24 < r < 0.54; P < 0.0001).In Kenya, as in other developing countries, invasive pneumococcal disease (IPD) is responsible for substantial morbidity and mortality (6, 8). In populations for which incidence data are available, the risk of IPD peaks at the end of the first and beginning of the second year of life, declining sharply thereafter. Disease incidence remains low through puberty and early adulthood, rises gradually through middle age, and increases dramatically for individuals over 65 (15,18,23). Recent largescale efficacy trials have shown that a 7-valent pneumococcal conjugate vaccine is effective against IPD and, to a lesser extent, against pneumonia caused by vaccine types (3,12,17). Unfortunately, the price of this vaccine will likely preclude its inclusion in national immunization programs for many countries with the greatest burden of pneumococcal disease. Recent studies also suggest that coverage for such multivalent vaccines may not be universally optimal across the developing world (7, 9). Furthermore, it remains unclear whether serotype replacement will result in significant increases in non-vaccine-type disease in the face of widespread conjugate vaccine use (16). Streptococcus pneumoniae vaccines based on conserved pneumococcal protein antigens such as pneumococcal surface protein A (PspA), pneumolysin, and pneumococcal surface adhesin A (PsaA) are currently under study (4, 5) and, if proven effective, may provide an alternative that is less expensive while affording greater coverage.Immunity to PspA, pneumolysin, and PsaA in European adults and children with and without pneumococcal disease has been studied extensively (20)(21)(22). To the best of our knowledge, the development of naturally acquired immunity to these three antigens in an African population has not yet been described. In...

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“…Streptococcus pneumoniae is a recognised resident in the upper respiratory tract [15], being found in the oropharynx of 35 % of pre-school children, 20 % of healthy adults and up to 40 % of patients with chronic bronchitis [16,17]. Hendley and coworkers found that the most common serotype was type 19 [16].…”

Section: Discussionmentioning

confidence: 99%

“…Hendley and coworkers found that the most common serotype was type 19 [16]. The release, by these oropharyngeal organisms, of antigens into saliva has not been studied extensively.…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal production of pneumococcal capsular antigen and the potential for contamination of expectorated sputum samples in pneumococcal pneumonia

et al. 1993

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SUMMARYThe presence of pneumococcal capsular antigen (PCA) in the oropharynx was sought in subjects without respiratory tract infection. Saliva specimens from 239 subjects were analysed by counter-current immunoelectrophoresis using 'Omniserum'. 15 5% gave positive reactions but only 24% of positive samples were typable and therefore due to pneumococcal or pneumococcal-like antigens. Given that oropharyngeal production of antigens occurs we investigated whether PCA in expectorated sputum arose from oropharyngeal contamination. Sixteen patients with pneumococcal pneumonia, and with sputum positive for PCA, were investigated in detail. On the basis of serotyping and concentration the PCA in sputum was thought to arise from the lower respiratory tract in all cases. This was confirmed by a simple, novel approach involving the comparison of concentrations in concomitant samples of saliva and sputum. Thus while oropharyngeal production of antigens poses a potential diagnostic problem the latter approach can be used to exclude contamination.

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Spread of Streptococcus pneumoniae in Families. I. Carriage Rates and Distribution of Types

Cited by 258 publications

References 12 publications

Pneumococcal carriage amongst children in Adelaide, South Australia

Pneumococcal carriage amongst children in Adelaide, South Australia

Age-Specific Immunoglobulin G (IgG) and IgA to Pneumococcal Protein Antigens in a Population in Coastal Kenya

Oropharyngeal production of pneumococcal capsular antigen and the potential for contamination of expectorated sputum samples in pneumococcal pneumonia

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