Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Community-Based Outbreaks in Vulnerable Populations of Invasive Infections Caused by Streptococcus pneumoniae Serotypes 5 and 8 in Calgary, Canada
Otto G. Vanderkooi<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>,</SUP><SUP>3</SUP><SUP>*</SUP>, Deirdre L. Church<SUP>1</SUP><SUP>,</SUP><SUP>3</SUP>, Judy MacDonald<SUP>1</SUP><SUP>,</SUP><SUP>4</SUP>, Franziska Zucol<SUP>2</SUP>, James D. Kellner<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>
1 University of Calgary, Calgary, Canada, 2 Alberta Children's Hospital, Alberta Health Services, Calgary, Canada, 3 Calgary Laboratory Services, Calgary, Canada, 4 Public Health Portfolio, Alberta Health Services ? Calgary Zone, Calgary, Canada
Abstract
Background
Outbreaks of invasive pneumococcal disease (IPD) typically occur within institutions. Beginning in 2005, we detected an increase in serotype (ST) 5 and ST8 IPD cases, predominantly in homeless persons living in an open community.
Methodology/Principal Findings
CASPER (Calgary Area S. pneumoniae Epidemiology Research) surveillance study of all IPD (sterile site isolates) in our region (pop ~1,100,000). Interviews and chart reviews of all cases and all isolates phenotypically analyzed and selected isolated tested by multi-locus sequence typing (MLST).
Conclusions/Significance
During 2005?2007, 162 cases of ST5 IPD and 45 cases of ST8 IPD were identified. The isolates demonstrated phenotypic and genotypic clonality. The ST5 isolates were sequence type (ST) 289 and demonstrated intermediate susceptibility to TMP-SMX. The ST8 isolates were predominantly ST1268, with a susceptible antimicrobial susceptibility profile. Individuals with ST5 IPD were more likely to be middle aged (OR 2.6), homeless (OR 4.4), using illicit drugs(OR 4.8), and asthmatic(OR 2.6). Those with ST8 were more likely to be male (OR 4.4), homeless (OR 2.6), aboriginal (OR7.3), and a current smoker (OR 2.5). Overlapping outbreaks of ST5 and ST8 IPD occurred in an open community in Calgary, Canada and homelessness was a predominant risk factor. Homelessness represents a unique community in which pneumococcal outbreaks can occur.
Citation: Vanderkooi OG, Church DL, MacDonald J, Zucol F, Kellner JD (2011) Community-Based Outbreaks in Vulnerable Populations of Invasive Infections Caused by Streptococcus pneumoniae Serotypes 5 and 8 in Calgary, Canada. PLoS ONE 6(12): e28547. doi:10.1371/journal.pone.0028547
Editor: Ray Borrow, Health Protection Agency, United Kingdom
Received: June 30, 2011; Accepted: November 10, 2011; Published: December 27, 2011
Copyright: ? 2011 Vanderkooi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: Alberta Children's Hospital Foundation (operating grant) and Wyeth Canada (now Pfizer, Inc., an unrestricted, investigator-initiated, grant-in-aid). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: JDK has served as a consultant to Wyeth (Pfizer) and GlaxoSmithKline and has received research grants from Wyeth (Pfizer) for Surveillance and Vaccine Evaluation Projects and from Wyeth (Pfizer) and GSK for vaccine clinical trials. OGV has received research grants from Wyeth (Pfizer) and GSK for vaccine clinical trials. He has participated in an expert panel meeting for GSK and Novartis. JM, FZ and DLC declare no conflicts of interest. This does not alter the authors′ adherence to all the PLoS ONE policies on sharing data and materials.
* E-mail: ovanderk@ucalgary.ca
- --------Otto G. Vanderkooi<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>,</SUP><SUP>3</SUP><SUP>*</SUP>, Deirdre L. Church<SUP>1</SUP><SUP>,</SUP><SUP>3</SUP>, Judy MacDonald<SUP>1</SUP><SUP>,</SUP><SUP>4</SUP>, Franziska Zucol<SUP>2</SUP>, James D. Kellner<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>
1 University of Calgary, Calgary, Canada, 2 Alberta Children's Hospital, Alberta Health Services, Calgary, Canada, 3 Calgary Laboratory Services, Calgary, Canada, 4 Public Health Portfolio, Alberta Health Services ? Calgary Zone, Calgary, Canada
Abstract
Background
Outbreaks of invasive pneumococcal disease (IPD) typically occur within institutions. Beginning in 2005, we detected an increase in serotype (ST) 5 and ST8 IPD cases, predominantly in homeless persons living in an open community.
Methodology/Principal Findings
CASPER (Calgary Area S. pneumoniae Epidemiology Research) surveillance study of all IPD (sterile site isolates) in our region (pop ~1,100,000). Interviews and chart reviews of all cases and all isolates phenotypically analyzed and selected isolated tested by multi-locus sequence typing (MLST).
Conclusions/Significance
During 2005?2007, 162 cases of ST5 IPD and 45 cases of ST8 IPD were identified. The isolates demonstrated phenotypic and genotypic clonality. The ST5 isolates were sequence type (ST) 289 and demonstrated intermediate susceptibility to TMP-SMX. The ST8 isolates were predominantly ST1268, with a susceptible antimicrobial susceptibility profile. Individuals with ST5 IPD were more likely to be middle aged (OR 2.6), homeless (OR 4.4), using illicit drugs(OR 4.8), and asthmatic(OR 2.6). Those with ST8 were more likely to be male (OR 4.4), homeless (OR 2.6), aboriginal (OR7.3), and a current smoker (OR 2.5). Overlapping outbreaks of ST5 and ST8 IPD occurred in an open community in Calgary, Canada and homelessness was a predominant risk factor. Homelessness represents a unique community in which pneumococcal outbreaks can occur.
Citation: Vanderkooi OG, Church DL, MacDonald J, Zucol F, Kellner JD (2011) Community-Based Outbreaks in Vulnerable Populations of Invasive Infections Caused by Streptococcus pneumoniae Serotypes 5 and 8 in Calgary, Canada. PLoS ONE 6(12): e28547. doi:10.1371/journal.pone.0028547
Editor: Ray Borrow, Health Protection Agency, United Kingdom
Received: June 30, 2011; Accepted: November 10, 2011; Published: December 27, 2011
Copyright: ? 2011 Vanderkooi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: Alberta Children's Hospital Foundation (operating grant) and Wyeth Canada (now Pfizer, Inc., an unrestricted, investigator-initiated, grant-in-aid). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: JDK has served as a consultant to Wyeth (Pfizer) and GlaxoSmithKline and has received research grants from Wyeth (Pfizer) for Surveillance and Vaccine Evaluation Projects and from Wyeth (Pfizer) and GSK for vaccine clinical trials. OGV has received research grants from Wyeth (Pfizer) and GSK for vaccine clinical trials. He has participated in an expert panel meeting for GSK and Novartis. JM, FZ and DLC declare no conflicts of interest. This does not alter the authors′ adherence to all the PLoS ONE policies on sharing data and materials.
* E-mail: ovanderk@ucalgary.ca