Abstract
Streptococcus pneumoniae (S. pneumoniae) vaccines have substantially reduced the burden of invasive pneumococcal diseases (IPDs) worldwide. Despite high coverage with S. pneumoniae vaccination, upper-respiratory-tract colonization by S. pneumoniae is still common. We assessed maintenance of serological responses to S. pneumoniae serotypes included in PCV-10 by ELISA in HIV-1-infected children (n = 50) and age-matched controls (n = 50) in Ethiopia. We isolated S. pneumoniae in nasopharyngeal swabs and determined S. pneumoniae serotype by whole genome sequencing (WGS). Comparable levels of S. pneumoniae serotype-specific IgG concentrations were detected in plasma of HIV-1-infected children and matched controls, with geometric mean concentrations (GMCs) consistently higher than the protective threshold for PCV-10 serotypes of 0.35 µg/mL. We isolated S. pneumoniae from 38 (out of 97) nasopharyngeal swabs, 25 from HIV-1-infected children and 13 from controls. WGS based serotyping revealed 22 known S. pneumoniae serotypes and 2 nontypeable (NT) isolates. Non-PCV-10 serotypes represented >90% of isolates. We showed that HIV-1-infected children and matched controls in Ethiopia carry a level of maintained serological memory to PCV-10 considered protective for IPDs. We identified a higher proportion of nasopharyngeal carriage with highly pathogenic S. pneumoniae non-PCV strains among HIV-1-infected children compared to controls.
Highlights
Streptococcus pneumoniae (S. pneumoniae), part of the normal flora in the upper respiratory tract, can cause severe noninvasive and invasive diseases [1,2]
Results from whole-genome sequencing (WGS)-based pneumococcal serotyping showed that 36 S. pneumoniae isolates comprised 22 known serotypes and 2 isolates classified as nontypeable (NT)
PCV-10 serotypes are responsible for 8% of the carriage in HIV-1-infected children and were not detected in the serotypes isolated (n = 13) from age-matched controls
Summary
Streptococcus pneumoniae (S. pneumoniae), part of the normal flora in the upper respiratory tract, can cause severe noninvasive (pneumonia, sinusitis, otitis) and invasive (bacteremia and meningitis) diseases [1,2]. Based on the variability of capsular antigens, more than 90 serotypes have been described [3]; among these are opportunistic pathogens which can cause different noninvasive and invasive pneumococcal diseases (IPD). Colonization of the upper respiratory tract is the initial step for all forms of pneumococcal disease, and the rate of colonization is higher at an early age [4]. The risk of IPD and community-acquired pneumonia (CAP) was significantly increased during HIV-1 infection and in individuals less than 5 years and older than 65 years of age [6,7,8]. In 2017, S. pneumoniae was classified as one of the 12 priority pathogens [9]
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