tetano
Editor, Senior Moderator
Proc Biol Sci. 2013 Jun 19;280(1764):20130519. Print 2013.
Assessing pneumococcal meningitis association with viral respiratory infections and antibiotics: insights from statistical and mathematical models.
Opatowski L, Varon E, Dupont C, Temime L, van der Werf S, Gutmann L, Bo?lle PY, Watier L, Guillemot D.
Source
Unit? de Pharmaco-?pid?miologie et Maladies Infectieuses (PhEMI), Institut Pasteur, , 75015 Paris, France, INSERM, , U 657, 75015 Paris, France, Facult? de M?decine Paris Ile de France Ouest, Universit? Versailles Saint Quentin, , EA 4499, 78035 Versailles, France, Department of Infectious Disease Epidemiology, Imperial College London, , London, UK, Centre National de R?f?rence des Pneumocoques, H?pital Europ?en Georges Pompidou, Assistance Publique H?pitaux de Paris, , Paris, France, Conservatoire national des arts et m?tiers, Laboratoire Mod?lisation et surveillance des risques pour la s?curit? sanitaire, , Paris, France, Unit? de G?n?tique Mol?culaire des Virus ? ARN, Institut Pasteur, , 75724 Paris, France, CNRS UMR 3569, , 75724 Paris, France, Unit? de G?n?tique Mol?culaire des Virus ? ARN, Univ. Paris Diderot Sorbonne Paris Cit?, , 75724 Paris, France, INSERM U707, , Paris, France, UMR S 707, , Paris, France, H?pital Saint-Antoine, Assistance Publique H?pitaux de Paris, , Paris, France, Unit? Fonctionnelle de Sant? Publique, H?pital Raymond Poincar?, , Assistance Publique H?pitaux de Paris, France, F-92380 Garches, France.
Abstract
Pneumococcus is an important human pathogen, highly antibiotic resistant and a major cause of bacterial meningitis worldwide. Better prevention requires understanding the drivers of pneumococcal infection incidence and antibiotic susceptibility. Although respiratory viruses (including influenza) have been suggested to influence pneumococcal infections, the underlying mechanisms are still unknown, and viruses are rarely considered when studying pneumococcus epidemiology. Here, we propose a novel mathematical model to examine hypothetical relationships between Streptococcus pneumoniae meningitis incidence (SPMI), acute viral respiratory infections (AVRIs) and antibiotic exposure. French time series of SPMI, AVRI and penicillin consumption over 2001-2004 are analysed and used to assess four distinct virus-bacteria interaction submodels, ascribing the interaction on pneumococcus transmissibility and/or pathogenicity. The statistical analysis reveals strong associations between time series: SPMI increases shortly after AVRI incidence and decreases overall as the antibiotic-prescription rate rises. Model simulations require a combined impact of AVRI on both pneumococcal transmissibility (up to 1.3-fold increase at the population level) and pathogenicity (up to threefold increase) to reproduce the data accurately, along with diminished epidemic fitness of resistant pneumococcal strains causing meningitis (0.97 (0.96-0.97)). Overall, our findings suggest that AVRI and antibiotics strongly influence SPMI trends. Consequently, vaccination protecting against respiratory virus could have unexpected benefits to limit invasive pneumococcal infections.
KEYWORDS:
Streptococcus pneumonia meningitis, antibiotic resistance fitness cost, influenza, mathematical model, statistical model, virus?bacteria interaction
PMID:
23782877
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23782877
Assessing pneumococcal meningitis association with viral respiratory infections and antibiotics: insights from statistical and mathematical models.
Opatowski L, Varon E, Dupont C, Temime L, van der Werf S, Gutmann L, Bo?lle PY, Watier L, Guillemot D.
Source
Unit? de Pharmaco-?pid?miologie et Maladies Infectieuses (PhEMI), Institut Pasteur, , 75015 Paris, France, INSERM, , U 657, 75015 Paris, France, Facult? de M?decine Paris Ile de France Ouest, Universit? Versailles Saint Quentin, , EA 4499, 78035 Versailles, France, Department of Infectious Disease Epidemiology, Imperial College London, , London, UK, Centre National de R?f?rence des Pneumocoques, H?pital Europ?en Georges Pompidou, Assistance Publique H?pitaux de Paris, , Paris, France, Conservatoire national des arts et m?tiers, Laboratoire Mod?lisation et surveillance des risques pour la s?curit? sanitaire, , Paris, France, Unit? de G?n?tique Mol?culaire des Virus ? ARN, Institut Pasteur, , 75724 Paris, France, CNRS UMR 3569, , 75724 Paris, France, Unit? de G?n?tique Mol?culaire des Virus ? ARN, Univ. Paris Diderot Sorbonne Paris Cit?, , 75724 Paris, France, INSERM U707, , Paris, France, UMR S 707, , Paris, France, H?pital Saint-Antoine, Assistance Publique H?pitaux de Paris, , Paris, France, Unit? Fonctionnelle de Sant? Publique, H?pital Raymond Poincar?, , Assistance Publique H?pitaux de Paris, France, F-92380 Garches, France.
Abstract
Pneumococcus is an important human pathogen, highly antibiotic resistant and a major cause of bacterial meningitis worldwide. Better prevention requires understanding the drivers of pneumococcal infection incidence and antibiotic susceptibility. Although respiratory viruses (including influenza) have been suggested to influence pneumococcal infections, the underlying mechanisms are still unknown, and viruses are rarely considered when studying pneumococcus epidemiology. Here, we propose a novel mathematical model to examine hypothetical relationships between Streptococcus pneumoniae meningitis incidence (SPMI), acute viral respiratory infections (AVRIs) and antibiotic exposure. French time series of SPMI, AVRI and penicillin consumption over 2001-2004 are analysed and used to assess four distinct virus-bacteria interaction submodels, ascribing the interaction on pneumococcus transmissibility and/or pathogenicity. The statistical analysis reveals strong associations between time series: SPMI increases shortly after AVRI incidence and decreases overall as the antibiotic-prescription rate rises. Model simulations require a combined impact of AVRI on both pneumococcal transmissibility (up to 1.3-fold increase at the population level) and pathogenicity (up to threefold increase) to reproduce the data accurately, along with diminished epidemic fitness of resistant pneumococcal strains causing meningitis (0.97 (0.96-0.97)). Overall, our findings suggest that AVRI and antibiotics strongly influence SPMI trends. Consequently, vaccination protecting against respiratory virus could have unexpected benefits to limit invasive pneumococcal infections.
KEYWORDS:
Streptococcus pneumonia meningitis, antibiotic resistance fitness cost, influenza, mathematical model, statistical model, virus?bacteria interaction
PMID:
23782877
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23782877