Streptococcus pneumoniae colonisation: the key to pneumococcal disease

Bogaert, Debby; Groot, Ronald de; Hermans, Peter W. M.

doi:10.1016/s1473-3099(04)00938-7

Cited by 1,680 publications

(1,659 citation statements)

References 135 publications

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“…The previous studies reported carrier rates of pneumococci in children as 2-10 % in Italy, 21-23 % in the USA, 20-70 % in Asia [25] and for the carrier rates of BHS: 8 % in Croatia and 16 % in India [26,27]. One meta-analysis study reported that the pool prevalence of group A streptococcus (GAS) carriage in children of all ages was 12 % (95 % CI 9-14 %) [28].…”

Section: Discussionmentioning

confidence: 96%

Antibiotic Resistance Patterns and Related Mobile Genetic Elements of Pneumococci and β-Hemolytic Streptococci in Thai Healthy Children

et al. 2016

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Transmission of antibiotic resistance genes among Streptococcus pneumoniae and beta-hemolytic streptococcus (BHS) was generally associated with transmissible genetic elements. The objectives of this study were to investigate carriage rate, antibiotic resistance and related mobile genetic elements of pneumococci and BHS from school-children. The pneumococci and BHS were recovered from 220 Thai school-children, and then tested for antibiotic susceptibility pattern by disc diffusion. Antibiotic resistance genes and related genetic elements were detected by PCR with specific primers. A total of 77 pneumococcal isolates were resistant to erythromycin (42 %), tetracycline (44 %), clindamycin (8 %), or penicillin (3 %). Fifty-four BHS isolates were resistant to erythromycin (28 %), tetracycline (52 %), or clindamycin (13 %). All isolates tested were 100 % sensitive to penicillin and levofloxacin. Among erythromycin-resistant streptococcal isolates showed different phenotypes of clindamycin resistance. It was found that isolated pneumococci showed constitutive clindamycin resistance (19 %), and inducible clindamycin resistance (12 %). The BHS isolates exhibited constitutive clindamycin resistance (40 %), and inducible resistance (20 %) phenotypes. The predominant erythromycin resistance genes in pneumococci and BHS were mefE and ermB, while the most common tetracycline resistance gene in this population was tetM. Furthermore, almost all erythromycin-and tetracycline-resistant streptococci (97 %) mainly contained various genetic elements, including mega elements and six different transposon types (Tn2009, Tn2017, Tn917, Tn3872, Tn6002 and Tn916). Therefore, carriages of pneumococci and BHS with multidrug resistance in children might be important reservoirs of antibiotic-resistance genes carried by transposons. Tn916-like elements could lead to dissemination of the antibiotic resistance genes among genus streptococcus in human oral cavity and nasopharynx.

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Section: Discussionmentioning

confidence: 96%

Antibiotic Resistance Patterns and Related Mobile Genetic Elements of Pneumococci and β-Hemolytic Streptococci in Thai Healthy Children

et al. 2016

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“…A majority of individuals have been colonized by the pneumococcus, which correlates with the significant levels of anti-PPS specific antibody in adults [6,3,7]. Previously, we have demonstrated that streptococcal colonization can have a significant effect on subsequent pneumococcal vaccination [13].…”

Section: Discussionmentioning

confidence: 99%

“…Pneumococcal colonization is highly age dependent and over half of all children under the age of three have been colonized [3]. Colonization is self limiting, does not necessarily lead to disease, and can last from two to 18 weeks depending on the serotype.…”

Section: Introductionmentioning

confidence: 99%

B cell mediated priming following pneumococcal colonization

Rabquer

Shriner

Smithson

et al. 2007

Vaccine

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The primary reservoir for Streptococcus pneumoniae is the human nasopharynx, and colonization is often the initial step in pathogenesis. Recently we have demonstrated that pneumococcal colonization primes the immune response to subsequent vaccination with the pneumococcal conjugate vaccine (CPV). In this study we wished to determine if colonization stimulates the production of B cell memory that is activated following vaccination with CPV. To test this hypothesis, we colonized mice with S. pneumoniae serotype 14, adoptively transferred their B cells and CD4 + T cells into naïve recipients, and vaccinated the recipients with CPV. Our results indicate that pneumococcal colonization stimulates the production of memory B cells which are responsible for enhancing the immune response to CPV vaccination.

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“…Most cases of pneumococcal‐associated deaths and severe disease occur in low‐income countries in children < 6 months of age 1, 2. Nasopharyngeal colonization is an immediate precursor to disease 3, 4. In low‐income settings infants become colonized rapidly, with carriage often persisting into adulthood 5.…”

Section: Introductionmentioning

confidence: 99%

Cord blood Streptococcus pneumoniae-specific cellular immune responses predict early pneumococcal carriage in high-risk infants in Papua New Guinea

Francis

Richmond

Strickland

et al. 2016

Clinical and Experimental Immunology

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SummaryIn areas where Streptococcus pneumoniae is highly endemic, infants experience very early pneumococcal colonization of the upper respiratory tract, with carriage often persisting into adulthood. We aimed to explore whether newborns in high‐risk areas have pre‐existing pneumococcal‐specific cellular immune responses that may affect early pneumococcal acquisition. Cord blood mononuclear cells (CBMC) of 84 Papua New Guinean (PNG; high endemic) and 33 Australian (AUS; low endemic) newborns were stimulated in vitro with detoxified pneumolysin (dPly) or pneumococcal surface protein A (PspA; families 1 and 2) and compared for cytokine responses. Within the PNG cohort, associations between CBMC dPly and PspA‐induced responses and pneumococcal colonization within the first month of life were studied. Significantly higher PspA‐specific interferon (IFN)‐γ, tumour necrosis factor (TNF)‐α, interleukin (IL)‐5, IL‐6, IL‐10 and IL‐13 responses, and lower dPly‐IL‐6 responses were produced in CBMC cultures of PNG compared to AUS newborns. Higher CBMC PspA‐IL‐5 and PspA‐IL‐13 responses correlated with a higher proportion of cord CD4 T cells, and higher dPly‐IL‐6 responses with a higher frequency of cord antigen‐presenting cells. In the PNG cohort, higher PspA‐specific IL‐5 and IL‐6 CBMC responses were associated independently and significantly with increased risk of earlier pneumococcal colonization, while a significant protective effect was found for higher PspA‐IL‐10 CBMC responses. Pneumococcus‐specific cellular immune responses differ between children born in pneumococcal high versus low endemic settings, which may contribute to the higher risk of infants in high endemic settings for early pneumococcal colonization, and hence disease.

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Streptococcus pneumoniae colonisation: the key to pneumococcal disease

Cited by 1,680 publications

References 135 publications

Antibiotic Resistance Patterns and Related Mobile Genetic Elements of Pneumococci and β-Hemolytic Streptococci in Thai Healthy Children

Antibiotic Resistance Patterns and Related Mobile Genetic Elements of Pneumococci and β-Hemolytic Streptococci in Thai Healthy Children

B cell mediated priming following pneumococcal colonization

Cord blood Streptococcus pneumoniae-specific cellular immune responses predict early pneumococcal carriage in high-risk infants in Papua New Guinea

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