tetano
Editor, Senior Moderator
J Infect Dis. 2014 Jun 6. pii: jiu326. [Epub ahead of print]
High nasopharyngeal pneumococcal density, increased by viral co-infection, is associated with invasive pneumococcal pneumonia.
Wolter N1, Tempia S2, Cohen C3, Madhi SA4, Venter M5, Moyes J6, Walaza S6, Kgokong BM6, Groome M7, du Plessis M1, Magomani V8, Pretorius M6, Hellferscee O6, Dawood H9, Kahn K10, Variava E11, Klugman KP12, von Gottberg A1.
Author information
Abstract
BACKGROUND:
We identified factors associated with pneumococcal colonization, high colonization density and invasive pneumococcal pneumonia among patients hospitalized with acute lower respiratory-tract infections (ALRI).
METHODS:
In 2010, 4025 cases were enrolled in surveillance in South Africa. 969/4025 (24%) systematically-selected nasopharyngeal-oropharyngeal specimens were tested for respiratory viruses and S. pneumoniae by real-time PCR. Of these, 749 (77%) had blood tested for S. pneumoniae.
RESULTS:
Pneumococcal colonization was detected in 55% (534/969) of cases. On multivariable analysis controlling for age and tuberculosis treatment, infection with influenza (adjusted odd ratio (aOR):2.2, 95% confidence interval (CI): 1.1-4.5), adenovirus (aOR: 1.7, CI: 1.1-2.7), rhinovirus (aOR: 1.6, CI: 1.1-2.3) and HIV (aOR: 1.6, CI: 1.1-2.4) were associated with pneumococcal colonization. High colonization density was associated with respiratory virus co-infection (aOR: 1.7, CI: 1.1-2.6) and invasive pneumococcal pneumonia (aOR: 2.3, CI: 1.3-4.0), controlling for age and gender. 7% (52/749) had pneumococci detected in blood. On multivariable analysis among colonized cases, invasive pneumococcal pneumonia was associated with HIV (aOR: 3.2, CI: 1.4-7.5), influenza (aOR: 8.2, CI: 2.7-25.0), high colonization density (aOR: 18.7, CI: 2.3-155.1) and ≥5 days hospitalization (aOR: 3.7, CI: 1.7-8.2).
CONCLUSIONS:
Respiratory virus infection was associated with elevated colonization density and, in turn, invasive pneumococcal pneumonia.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID:
24907383
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24907383
High nasopharyngeal pneumococcal density, increased by viral co-infection, is associated with invasive pneumococcal pneumonia.
Wolter N1, Tempia S2, Cohen C3, Madhi SA4, Venter M5, Moyes J6, Walaza S6, Kgokong BM6, Groome M7, du Plessis M1, Magomani V8, Pretorius M6, Hellferscee O6, Dawood H9, Kahn K10, Variava E11, Klugman KP12, von Gottberg A1.
Author information
Abstract
BACKGROUND:
We identified factors associated with pneumococcal colonization, high colonization density and invasive pneumococcal pneumonia among patients hospitalized with acute lower respiratory-tract infections (ALRI).
METHODS:
In 2010, 4025 cases were enrolled in surveillance in South Africa. 969/4025 (24%) systematically-selected nasopharyngeal-oropharyngeal specimens were tested for respiratory viruses and S. pneumoniae by real-time PCR. Of these, 749 (77%) had blood tested for S. pneumoniae.
RESULTS:
Pneumococcal colonization was detected in 55% (534/969) of cases. On multivariable analysis controlling for age and tuberculosis treatment, infection with influenza (adjusted odd ratio (aOR):2.2, 95% confidence interval (CI): 1.1-4.5), adenovirus (aOR: 1.7, CI: 1.1-2.7), rhinovirus (aOR: 1.6, CI: 1.1-2.3) and HIV (aOR: 1.6, CI: 1.1-2.4) were associated with pneumococcal colonization. High colonization density was associated with respiratory virus co-infection (aOR: 1.7, CI: 1.1-2.6) and invasive pneumococcal pneumonia (aOR: 2.3, CI: 1.3-4.0), controlling for age and gender. 7% (52/749) had pneumococci detected in blood. On multivariable analysis among colonized cases, invasive pneumococcal pneumonia was associated with HIV (aOR: 3.2, CI: 1.4-7.5), influenza (aOR: 8.2, CI: 2.7-25.0), high colonization density (aOR: 18.7, CI: 2.3-155.1) and ≥5 days hospitalization (aOR: 3.7, CI: 1.7-8.2).
CONCLUSIONS:
Respiratory virus infection was associated with elevated colonization density and, in turn, invasive pneumococcal pneumonia.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PMID:
24907383
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24907383