tetano
Editor, Senior Moderator
Clin Infect Dis. (2014) doi: 10.1093/cid/ciu148 First published online: March 12, 2014
The role of influenza and parainfluenza infections in nasopharyngeal pneumococcal acquisition among young children
Carlos G. Grijalva,
Marie R. Griffin,
Kathryn M. Edwards,
John V. Williams,
Ana I. Gil,
Hector Verastegui,
Stella M. Hartinger,
Jorge E. Vidal,
Keith P. Klugman, and
Claudio F. Lanata
Vanderbilt University School of Medicine, Nashville - TN. Departments of Preventive Medicine, (CGG, MRG), Pediatrics (KME, JVW), and Pathology, Microbiology, and Immunology (JVW); Instituto de Investigaci?n Nutricional, Lima - Peru (AG, HV, SH, CFL); and, Rollins School of Public Health, Emory University, Atlanta - GA (JEV, KPK)
Corresponding author: Carlos G. Grijalva, MD MPH, Department of Preventive Medicine, Vanderbilt University School of Medicine, 1500 21st Avenue South, The Village at Vanderbilt Suite # 2600, Nashville, TN 37212, Phone: (615) 343 5499, E-mail: Carlos.grijalva{at}vanderbilt.edu
Alternate Corresponding author: Marie R Griffin MD MPH, Professor of Medicine and Health Policy, Department of Health Policy, Vanderbilt University School of Medicine, 1500 21st Ave S, Village at Vanderbilt, Suite 2600, Nashville TN 37212, Phone: (615)-343-6338, E-mail: Marie.griffin{at}vanderbilt.edu
Abstract
Background. Since animal models suggest that influenza infection favors nasopharyngeal acquisition of pneumococci, we assessed this relationship with influenza and other respiratory viruses in young children.
Methods. A case-control study was nested within a prospective cohort study of acute respiratory illness (ARI) in Andean children <3 years of age (RESPIRA-PERU study). Weekly household visits were made to identify ARI and obtain nasal swabs for viral detection using RT-PCR. Monthly nasopharyngeal (NP) samples were obtained to assess pneumococcal colonization. We determined whether specific respiratory viral ARI episodes occurring within the interval between NP samples increased the risk of nasopharyngeal acquisition of new pneumococcal serotypes.
Results. A total of 729 children contributed 2128 episodes of observation, including 681 pneumococcal acquisition episodes (new serotype compared to prior sample), 1029 non-acquisition episodes (no colonization or persistent colonization with the same serotype as the prior sample) and 418 indeterminate episodes. The risk of pneumococcal acquisition increased following influenza-ARI (adjusted odds ratio: 2.19, 95% CI: 1.02-4.69) and parainfluenza-ARI (1.86, 95% CI: 1.15-3.01), when compared with episodes without ARI. Other viral infections (respiratory syncytial virus, human metapneumovirus, human rhinovirus and adenovirus) were not associated with acquisition.
Conclusions. Influenza and parainfluenza ARIs appeared to facilitate pneumococcal acquisition among young children. As acquisition increases the risk of pneumococcal diseases, these observations are pivotal in our attempts to prevent pneumococcal disease.
http://cid.oxfordjournals.org/content/early/2014/03/12/cid.ciu148.short
The role of influenza and parainfluenza infections in nasopharyngeal pneumococcal acquisition among young children
Carlos G. Grijalva,
Marie R. Griffin,
Kathryn M. Edwards,
John V. Williams,
Ana I. Gil,
Hector Verastegui,
Stella M. Hartinger,
Jorge E. Vidal,
Keith P. Klugman, and
Claudio F. Lanata
Vanderbilt University School of Medicine, Nashville - TN. Departments of Preventive Medicine, (CGG, MRG), Pediatrics (KME, JVW), and Pathology, Microbiology, and Immunology (JVW); Instituto de Investigaci?n Nutricional, Lima - Peru (AG, HV, SH, CFL); and, Rollins School of Public Health, Emory University, Atlanta - GA (JEV, KPK)
Corresponding author: Carlos G. Grijalva, MD MPH, Department of Preventive Medicine, Vanderbilt University School of Medicine, 1500 21st Avenue South, The Village at Vanderbilt Suite # 2600, Nashville, TN 37212, Phone: (615) 343 5499, E-mail: Carlos.grijalva{at}vanderbilt.edu
Alternate Corresponding author: Marie R Griffin MD MPH, Professor of Medicine and Health Policy, Department of Health Policy, Vanderbilt University School of Medicine, 1500 21st Ave S, Village at Vanderbilt, Suite 2600, Nashville TN 37212, Phone: (615)-343-6338, E-mail: Marie.griffin{at}vanderbilt.edu
Abstract
Background. Since animal models suggest that influenza infection favors nasopharyngeal acquisition of pneumococci, we assessed this relationship with influenza and other respiratory viruses in young children.
Methods. A case-control study was nested within a prospective cohort study of acute respiratory illness (ARI) in Andean children <3 years of age (RESPIRA-PERU study). Weekly household visits were made to identify ARI and obtain nasal swabs for viral detection using RT-PCR. Monthly nasopharyngeal (NP) samples were obtained to assess pneumococcal colonization. We determined whether specific respiratory viral ARI episodes occurring within the interval between NP samples increased the risk of nasopharyngeal acquisition of new pneumococcal serotypes.
Results. A total of 729 children contributed 2128 episodes of observation, including 681 pneumococcal acquisition episodes (new serotype compared to prior sample), 1029 non-acquisition episodes (no colonization or persistent colonization with the same serotype as the prior sample) and 418 indeterminate episodes. The risk of pneumococcal acquisition increased following influenza-ARI (adjusted odds ratio: 2.19, 95% CI: 1.02-4.69) and parainfluenza-ARI (1.86, 95% CI: 1.15-3.01), when compared with episodes without ARI. Other viral infections (respiratory syncytial virus, human metapneumovirus, human rhinovirus and adenovirus) were not associated with acquisition.
Conclusions. Influenza and parainfluenza ARIs appeared to facilitate pneumococcal acquisition among young children. As acquisition increases the risk of pneumococcal diseases, these observations are pivotal in our attempts to prevent pneumococcal disease.
http://cid.oxfordjournals.org/content/early/2014/03/12/cid.ciu148.short