Abstract
BackgroundThe main aim of this study was to evaluate Streptococcus pneumoniae carriage in a group of school-aged children and adolescents with asthma because these results might indicate the theoretical risk of invasive pneumococcal disease (IPD) of such patients and the potential protective efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13).MethodsOropharyngeal samples were obtained from 423 children with documented asthma (300 males, 70.9 %), and tested for the autolysin-A-encoding (lytA) and the wzg (cpsA) gene of S. pneumoniae by means of real-time polymerase chain reaction.Results S. pneumoniae was identified in the swabs of 192 subjects (45.4 %): 48.4 % of whom were aged <10 years, 46.9 % aged 10–14 years, and 4.7 % aged ≥15 years (p < 0.001). Carriage was significantly less frequent among the children who had received recent antibiotic therapy (odds ratio [OR 0.41]; 95 % confidence interval [95 % CI] 0.22–0.76). Multivariate analyses showed no association between carriage and vaccination status, with ORs of 1.05 (95 % CI 0.70–1.58) for carriers of any pneumococcal serotype, 1.08 (95 % CI 0.72–1.62) for carriers of any of the serotypes included in 7-valent pneumococcal conjugate vaccine (PCV7), and 0.76 (95 % CI 0.45–1.28) for carriers of any of the six additional serotypes of PCV13. Serotypes 19 F, 4 and 9 V were the most frequently identified serotypes in vaccinated subjects.ConclusionsThese results showed that carriage of S. pneumoniae is relatively common in all school-aged children and adolescents with asthma, regardless of the severity of disease and the administration of PCV7 in the first years of life. This highlights the problem of the duration of the protection against colonisation provided by pneumococcal conjugate vaccine, and the importance of re-colonization by the same pneumococcal serotypes included in the previously used vaccine.
Highlights
The main aim of this study was to evaluate Streptococcus pneumoniae carriage in a group of school-aged children and adolescents with asthma because these results might indicate the theoretical risk of invasive pneumococcal disease (IPD) of such patients and the potential protective efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13)
Esposito et al BMC Infectious Diseases (2016) 16:12 (Continued from previous page). These results showed that carriage of S. pneumoniae is relatively common in all school-aged children and adolescents with asthma, regardless of the severity of disease and the administration of 7-valent pneumococcal conjugate vaccine (PCV7) in the first years of life
This highlights the problem of the duration of the protection against colonisation provided by pneumococcal conjugate vaccine, and the importance of re-colonization by the same pneumococcal serotypes included in the previously used vaccine
Summary
The main aim of this study was to evaluate Streptococcus pneumoniae carriage in a group of school-aged children and adolescents with asthma because these results might indicate the theoretical risk of invasive pneumococcal disease (IPD) of such patients and the potential protective efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13). The most recent recommendations indicate that school-aged children and adolescents with asthma should receive the 23-valent polysaccharide vaccine (PPSV23) rather than the 13-valent conjugate vaccine (PCV13) [3] This decision may be questioned because, it contains fewer pneumococcal serotypes than PPSV23, PCV13 may offer greater protection as it is more immunogenic [4] and has a significantly greater effect on pharyngeal carriage [5]. As evaluating pneumococcal colonisation is considered a possible means of measuring the efficacy of conjugate vaccine [8], the characteristics of carriage before vaccination may offer information regarding its potential coverage and real efficacy
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