Kim M Hare1, Heidi C Smith-Vaughan2, Anne B Chang3, Susan Pizzutto2, Helen L Petsky4, Gabrielle B McCallum2, Amanda J Leach2. 1. Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia. Electronic address: Kim.Hare@menzies.edu.au. 2. Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia. 3. Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia; Queensland Children's Health Service and Queensland University of Technology, Graham Street, South Brisbane, QLD 4101, Australia. 4. Queensland Children's Health Service and Queensland University of Technology, Graham Street, South Brisbane, QLD 4101, Australia.
Abstract
BACKGROUND: Chronic endobronchial infections in children are responsible for a high disease burden. Streptococcus pneumoniae is frequently isolated; however, few publications have described serotypes associated with non-invasive lower airway infection. METHODS: Paired nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids were collected from children undergoing bronchoscopy for chronic cough. NP swabs were also collected from asymptomatic children in otitis media surveillance studies (controls). Specimens were processed and lower airway infection defined (⩾104 colony forming units/mL BAL) as previously described. Serotype-specific odds ratios (ORs) were calculated (as described for invasive pneumococcal disease) to indicate propensity for infection. RESULTS: From 2007-2015, paired specimens were processed from 435 children with protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) or bronchiectasis. S. pneumoniae lower airway infection was detected in 95 children: 27% with PBB and 20% with CSLD/bronchiectasis. Most (91%) children were vaccinated with ⩾2 doses of 7-valent, 10-valent or 13-valent pneumococcal conjugate vaccine. Paired NP and BAL serotype distributions were very similar; prevalent serotypes (>10 isolates) were 19A (9%), 19F, 6C, 35B, 15B, 16F, 15A, 15C, 23A, 23F and 11A. For 21 serotypes found in both NP and BAL specimens, ORs for infection were low; range 0.46 (serotype 23B) to 2.15 (serotype 6A). In the 2008-2013 surveillance studies, NP swabs were collected from 1565 asymptomatic children; 74% were pneumococcal carriers. For 21 of 22 serotypes found in both control NP swabs and BAL specimens, ORs for infection were similarly low; range 0.33 (serotype 23B) to 3.29 (serotype 22F); none was significantly different from 1. The exception was serotype 7B with OR 8.84 (95% CI 1.46, 38.1). CONCLUSIONS: Most NP carriage serotypes have a similar propensity to cause lower airway infection in children with suppurative lung diseases. Further development of pneumococcal vaccines is needed to prevent non-invasive disease caused by commonly carried serotypes.
BACKGROUND:Chronic endobronchial infections in children are responsible for a high disease burden. Streptococcus pneumoniae is frequently isolated; however, few publications have described serotypes associated with non-invasive lower airway infection. METHODS: Paired nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids were collected from children undergoing bronchoscopy for chronic cough. NP swabs were also collected from asymptomatic children in otitis media surveillance studies (controls). Specimens were processed and lower airway infection defined (⩾104 colony forming units/mL BAL) as previously described. Serotype-specific odds ratios (ORs) were calculated (as described for invasive pneumococcal disease) to indicate propensity for infection. RESULTS: From 2007-2015, paired specimens were processed from 435 children with protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) or bronchiectasis. S. pneumoniae lower airway infection was detected in 95 children: 27% with PBB and 20% with CSLD/bronchiectasis. Most (91%) children were vaccinated with ⩾2 doses of 7-valent, 10-valent or 13-valent pneumococcal conjugate vaccine. Paired NP and BAL serotype distributions were very similar; prevalent serotypes (>10 isolates) were 19A (9%), 19F, 6C, 35B, 15B, 16F, 15A, 15C, 23A, 23F and 11A. For 21 serotypes found in both NP and BAL specimens, ORs for infection were low; range 0.46 (serotype 23B) to 2.15 (serotype 6A). In the 2008-2013 surveillance studies, NP swabs were collected from 1565 asymptomatic children; 74% were pneumococcal carriers. For 21 of 22 serotypes found in both control NP swabs and BAL specimens, ORs for infection were similarly low; range 0.33 (serotype 23B) to 3.29 (serotype 22F); none was significantly different from 1. The exception was serotype 7B with OR 8.84 (95% CI 1.46, 38.1). CONCLUSIONS: Most NP carriage serotypes have a similar propensity to cause lower airway infection in children with suppurative lung diseases. Further development of pneumococcal vaccines is needed to prevent non-invasive disease caused by commonly carried serotypes.
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Authors: Amparo Escribano Montaner; Juan García de Lomas; José Ramón Villa Asensi; Oscar Asensio de la Cruz; Olga de la Serna Blázquez; Mikel Santiago Burruchaga; Pedro Mondéjar López; Alba Torrent Vernetta; Yang Feng; Melissa K Van Dyke; Janet Reyes; Pilar Garcia-Corbeira; Carla A Talarico Journal: Eur J Pediatr Date: 2018-06-14 Impact factor: 3.183
Authors: Anne B Chang; Maree Toombs; Mark D Chatfield; Remai Mitchell; Siew M Fong; Michael J Binks; Heidi Smith-Vaughan; Susan J Pizzutto; Karin Lust; Peter S Morris; Julie M Marchant; Stephanie T Yerkovich; Hannah O'Farrell; Paul J Torzillo; Carolyn Maclennan; David Simon; Holger W Unger; Hasthika Ellepola; Jens Odendahl; Helen S Marshall; Geeta K Swamy; Keith Grimwood Journal: Front Pediatr Date: 2022-01-17 Impact factor: 3.418