Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016

Milucky, Jennifer; Carvalho, M.; Rouphael, Nadine; Bennett, Nancy M.; Talbot, H. Keipp; Harrison, Lee H.; Farley, Monica M.; Walston, Jeremy D.; Pimenta, Fabiana Cristina; Lessa, Fernanda C.; Bower, Mary; McNair, Nina; Williams, S G; Presmanes, Emily; Tunali, Amy; Thomas, Stéphanie; Hollick, Rosemary; Langdon, Jacqueline M.; Sepehri, Amir Salar; Sharova, Anna

doi:10.1016/j.vaccine.2018.12.075

Cited by 25 publications

(26 citation statements)

References 27 publications

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“…In this study, 1.5% (45/2989) carried pneumococci based on NP and OP cultures. Of those, pneumococcus was isolated from 1.2% (n = 35) using NP swabs only, 0.1% (n = 4) from OP swabs only, and 0.2% (n = 6) from both sites, showing almost 10 times greater sensitivity of NP swabs for isolation [ 14 ]. Our study observed greater pneumococcal yield from NP swabs over OP swabs using culture, which aligns with findings from previous culture-based studies.…”

Section: Discussionmentioning

confidence: 99%

Limited Added Value of Oropharyngeal Swabs for Detecting Pneumococcal Carriage in Adults

Farrar

Odiembo

Odoyo

et al. 2020

Open Forum Infectious Diseases

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We compared pneumococcal isolation rates and evaluated the benefit of using oropharyngeal (OP) specimens in addition to nasopharyngeal (NP) specimens collected from adults in rural Kenya. Of 846 adults, 52.1% were colonized; pneumococci were detected from both NP and OP specimens in 23.5%, NP only in 22.9%, and OP only in 5.7%. PCV10-type strains were detected from both NP and OP in 3.4%, NP only in 4.1%, and OP only in 0.7%. Inclusion of OP swabs increased carriage detection by 5.7%, however, the added cost of collecting and processing OP specimens may justify exclusion from future carriage studies among adults.

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Section: Discussionmentioning

confidence: 99%

Limited Added Value of Oropharyngeal Swabs for Detecting Pneumococcal Carriage in Adults

Farrar

Odiembo

Odoyo

et al. 2020

Open Forum Infectious Diseases

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“…pneumoniae and H . influenzae detection by qPCR as shown by others [46]. Different clinical specimens and diagnostic methods have been utilized for detection of S .…”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in a Brazilian elderly cohort

et al. 2019

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We aimed to investigate the nasopharyngeal colonization (NPC) by Streptococcus pneumoniae , Haemophilus influenzae , and Staphylococcus aureus in the elderly population and to assess the demographic factors associated with NPC. This was an observational cohort study in which outpatients aged ≥60 years were enrolled from April to August 2017, with a follow-up visit from September through December 2017. Nasopharyngeal (NP) swabs were collected, bacteria were detected and isolated, and isolates were subjected to phenotypic and molecular characterization using standard microbiological techniques. At enrolment, the rates of S . aureus , methicillin-resistant S . aureus (MRSA), H . influenzae , and S . pneumoniae among 776 elderly outpatients were 15.9%, 2.3%, 2.5%, and 2.2%, respectively. Toxin production was detected in 21.1% of methicillin-susceptible S . aureus , and three SCC mec types were identified: II/IIb, IVa, and VI. At the follow-up visit, all carriage rates were similar (p > 0.05) to the rates at enrolment. Most of S . pneumoniae serotypes were not included in pneumococcal conjugate vaccines (PCVs), except for 7F, 3, and 19A. All strains of H . influenzae were non-typeable. Previous use of antibiotics and 23-valent pneumococcal polysaccharide vaccination (p < 0.05) were risk factors for S . aureus and MRSA carriage; S . aureus colonization was also associated with chronic kidney disease (p = 0.021). S . pneumoniae carriage was associated with male gender (p = 0.032) and an absence of diabetes (p = 0.034), while not receiving an influenza vaccine (p = 0.049) and chronic obstructive pulmonary disease (p = 0.031) were risk factors for H . influenzae colonization. The frailty of study participants was not associated with colonization status. We found a higher S . aureus carriage rate compared with the S . pneumoniae - and H . influenzae -carriage rates in a well-attended population in a geriatric outpatient clinic. This is one of the few studies conducted in Brazil that can support future colonization studies among elderly individuals.

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“…In a recent study of paired nasopharyngeal/oropharyngeal (NP/OP) specimens from 460 adults, 450 individuals (908 of 920 specimens) were culture negative for pneumococci (10). Isolation and characterization of nonpneumococcal strains of PCV serotypes 1 and 5 associated with the pneumococcal surveillance project (15) have been described (9,10), as have nonpneumococcal counterparts of cps12F and cps33F (9).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 5 serotypes that were first identified in pneumococci (6-8), 3 of them (serotypes 1, 2, and 5) have recently been characterized from nonpneumococcal commensal species (9)(10)(11)(12). Further, in recent adult upper respiratory tract (URT) carriage assays carried out in the United States and Kenya, nonpneumococcal species expressing these and several other serotypes appear to be more common than pneumococci of the same serotypes (9,10,(13)(14)(15). The observed directionality of horizontal transfer events, where pneumococci are most often observed as recipients of related mitis group DNA (16), and the abundance of cps loci shared between pneumococci and its close relative commensal species that reside in the URT in higher density (9,10,13), is consistent with pneumococcal serotype diversity originating in non-pneumococcal species.…”

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confidence: 99%

Nonpneumococcal Strains Recently Recovered from Carriage Specimens and Expressing Capsular Serotypes Highly Related or Identical to Pneumococcal Serotypes 2, 4, 9A, 13, and 23A

Gertz

Pimenta

Chochua

et al. 2021

mBio

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The polysaccharide capsule is a key virulence factor of Streptococcus pneumoniae. There are numerous epidemiologically important pneumococcal capsular serotypes, and recent findings have demonstrated that several of them are commonly found among nonpathogenic commensal species. Here, we describe 9 nonpneumococcal strains carrying close homologs of pneumococcal capsular biosynthetic (cps) loci that were discovered during recent pneumococcal carriage studies of adults in the United States and Kenya. Two distinct Streptococcus infantis strains cross-reactive with pneumococcal serotype 4 and carrying cps4-like capsular biosynthetic (cps) loci were recovered. Opsonophagocytic killing assays employing rabbit antisera raised against S. infantis US67cps4 revealed serotype 4-specific killing of both pneumococcal and nonpneumococcal strains. An S. infantis strain and two Streptococcus oralis strains, all carrying cps9A-like loci, were cross-reactive with pneumococcal serogroup 9 strains in immunodiffusion assays. Antiserum raised against S. infantis US64cps9A specifically promoted killing of serotype 9A and 9V pneumococcal strains as well as S. oralis serotype 9A strains. Serotype-specific PCR of oropharyngeal specimens from a recent adult carriage study in the United States indicated that such nonpneumococcal strains were much more common in this population than serotype 4 and serogroup 9 pneumococci. We also describe S. oralis and S. infantis strains expressing serotypes identical or highly related to serotypes 2, 13, and 23A. This study has expanded the known overlap of pneumococcal capsular serotypes with related commensal species. The frequent occurrence of nonpneumococcal strains in the upper respiratory tract that share vaccine and nonvaccine capsular serotypes with pneumococci could affect population immunity to circulating pneumococcal strains. IMPORTANCE The distributions and frequencies of individual pneumococcal capsular serotypes among nonpneumococcal strains in the upper respiratory tract are unknown and potentially affect pneumococcal serotype distributions among the population and immunity to circulating pneumococcal strains. Repeated demonstration that these nonpneumococcal strains expressing so-called pneumococcal serotypes are readily recovered from current carriage specimens is likely to be relevant to pneumococcal epidemiology, niche biology, and even to potential strategies of employing commensal live vaccines. Here, we describe multiple distinct nonpneumococcal counterparts for each of the pneumococcal conjugate vaccine (PCV) serotypes 4 and 9V. Additional data from contemporary commensal isolates expressing serotypes 2, 13, and 23A further demonstrate the ubiquity of such strains. Increased focus upon this serological overlap between S. pneumoniae and its close relatives may eventually prove that most, or possibly all, pneumococcal serotypes have counterparts expressed by the common upper respiratory tract commensal species Streptococcus mitis, Streptococcus oralis, and Streptococcus infantis.

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Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016

Cited by 25 publications

References 27 publications

Limited Added Value of Oropharyngeal Swabs for Detecting Pneumococcal Carriage in Adults

Limited Added Value of Oropharyngeal Swabs for Detecting Pneumococcal Carriage in Adults

Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in a Brazilian elderly cohort

Nonpneumococcal Strains Recently Recovered from Carriage Specimens and Expressing Capsular Serotypes Highly Related or Identical to Pneumococcal Serotypes 2, 4, 9A, 13, and 23A

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