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Chapter 9 : Pneumococcal Carriage

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Abstract:

The human nasopharynx is the principal ecological niche for the heterogeneous population of (the pneumococcus), which exists as 90 different capsular types or serotypes. The focus of this chapter is to understand the behavior of and the factors that affect it in its normal habitat, the human nasopharynx. It is important to clarify that studies which have explored risk factors for pneumococcal carriage have not made a distinction between acquisition and carriage; therefore, data from these studies reflect risk factors related to the prevalence of pneumococci in carriage. There are little direct epidemiological data which show that acquired immunity plays a role in modulating carriage of pneumococci. The increase and subsequent decrease in pneumococcal carriage between 0 and 4 years of age is consistent with acquired immunity playing a role in reducing carriage, but the only direct evidence for natural immunity playing a role in preventing acquisition and thereby reducing carriage comes from a recent human challenge study. The conjugate vaccines have a marked and reciprocal effect on the acquisition and carriage of nonvaccine serotypes. Two additional beneficial effects have been observed in the human population following administration of the conjugate vaccine. The first is a significant reduction in carriage of antibioticresistant pneumococci, which is perhaps not surprising given that the major antibiotic-resistant clones are mainly of vaccine serotypes; the second is a reduction in the acquisition and carriage of vaccine-associated pneumococci in unimmunized younger siblings of vaccine recipients.

Citation: Crook D, Brueggemann A, Peto T, Sleeman K. 2004. Pneumococcal Carriage, p 136-147. In Tuomanen E, Mitchell T, Morrison D, Spratt B (ed), The Pneumococcus. ASM Press, Washington, DC. doi: 10.1128/9781555816537.ch9
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FIGURE 1

The attack rate is the incidence of invasive pneumococcal disease (IPD) per incidence of pneumococcal acquisition. The median duration for each serotype was estimated from survival analysis of interval swabbing of the nasopharynx. The invasive disease incidence data were derived from national United Kingdom data from children under 2 years of age. Acquisition data and duration data were derived from a carriage study of two Oxford birth cohorts of children studied for 6 months (214 children) and 2 years (100 children). 1* is a crude estimate for serotype 1. As serotype 1 strains were only isolated from cases of invasive disease and not from the nasopharynx, the duration of carriage was assumed to be <6 weeks and the attack rate was estimated to be >60/100,000.

Citation: Crook D, Brueggemann A, Peto T, Sleeman K. 2004. Pneumococcal Carriage, p 136-147. In Tuomanen E, Mitchell T, Morrison D, Spratt B (ed), The Pneumococcus. ASM Press, Washington, DC. doi: 10.1128/9781555816537.ch9
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References

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1. Aniansson, G.,, B. Alm,, B. Andersson,, P. Larsson,, O. Nylen,, H. Peterson,, P. Rigner,, M. Svanborg,, and C. Svanborg. 1992. Nasopharyngeal colonization during the first year of life. J. Infect. Dis. 165( Suppl 1): S38 S42.
2. Austrian, R. 1986. Some aspects of the pneumococcal carrier state. J. Antimicrob. Chemother. 18(Suppl. A): 35 45.
3. Ciftci, E.,, U. Dogru,, D. Aysev,, E. Ince,, H. Guriz,, and U. D. Aysev. 2001. Investigation of risk factors for penicillin-resistant Streptococcus pneumoniae carriage in Turkish children. Pediatr. Int. 43: 385 390.
4. Coles, C. L.,, L. Rahmathullah,, R. Kanungo,, R. D. Thulasiraj,, J. Katz,, M. Santosham,, and J. M. Tielsch. 2002. Nasopharyngeal carriage of resistant pneumococci in young South Indian infants. Epidemiol. Infect. 129: 491 497.
5. Dagan, R.,, N. Givon-Lavi,, O. Zamir,, and D. Fraser. 2003. Effect of a nonavalent conjugate vaccine on carriage of antibiotic-resistant Streptococcus pneumoniae in day-care centers. Pediatr. Infect. Dis. J. 22: 532 540.
6. Dagan, R.,, N. Givon-Lavi,, O. Zamir,, M. Sikuler-Cohen,, L. Guy,, J. Janco,, P. Yagupsky,, and D. Fraser. 2002. Reduction of nasopharyngeal carriage of Streptococcus pneumoniae after administration of a 9-valent pneumococcal conjugate vaccine to toddlers attending day care centers. J. Infect. Dis. 185: 927 936.
7. Dagan, R.,, S. Gradstein,, I. Belmaker,, N. Porat,, Y. Siton,, G. Weber,, J. Janco,, and P. Yagupsky. 2000. An outbreak of Streptococcus pneumoniae serotype 1 in a closed community in southern Israel. Clin. Infect. Dis. 30: 319 321.
8. Dagan, R.,, E. Leibovitz,, D. Greenberg,, P. Yagupsky,, D. M. Fliss,, and A. Leiberman. 1998. Dynamics of pneumococcal nasopharyngeal colonization during the first days of antibiotic treatment in pediatric patients. Pediatr. Infect. Dis J. 17: 880 885.
9. Dagan, R.,, R. Melamed,, M. Muallem,, L. Piglansky,, D. Greenberg,, O. Abramson,, P. M. Mendelman,, N. Bohidar,, and P. Yagupsky. 1996. Reduction of nasopharyngeal carriage of pneumococci during the second year of life by a heptavalent conjugate pneumococcal vaccine. J. Infec. Dis. 174: 1271 1278.
10. Dagan, R.,, R. Melamed,, M. Muallem,, L. Piglansky,, and P. Yagupsky. 1996. Nasopharyngeal colonization in southern Israel with antibiotic- resistant pneumococci during the first 2 years of life: relation to serotypes likely to be included in pneumococcal conjugate vaccines. J. Infect. Dis. 174: 1352 1355.
11. Dagan, R.,, M. Muallem,, R. Melamed,, O. Leroy,, and P. Yagupsky. 1997. Reduction of pneumococcal nasopharyngeal carriage in early infancy after immunization with tetravalent pneumococcal vaccines conjugated to either tetanus toxoid or diphtheria toxoid. Pediatr. Infect. Dis. J. 16: 1060 1064.
12. Dowling, J. N.,, P. R. Sheehe,, and H. A. Feldman. 1971. Pharyngeal pneumococcal acquisitions in “normal” families: a longitudinal study. J. Infect. Dis. 124: 9 17.
13. Duffy, L. C.,, H. Faden,, R. Wasielewski,, J. Wolf,, and D. Krystofik. 1997. Exclusive breastfeeding protects against bacterial colonization and day care exposure to otitis media. Pediatrics 100: E7.
14. Dunais, B.,, C. Pradier,, H. Carsenti,, M. Sabah,, G. Mancini,, E. Fontas,, and P. Dellamonica. 2003. Influence of child care on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae. Pediatr. Infect. Dis. J. 22: 589 592.
15. Faden, H.,, M. J. Waz,, J. M. Bernstein,, L. Brodsky,, J. Stanievich,, and P. L. Ogra. 1991. Nasopharyngeal flora in the first three years of life in normal and otitis-prone children. Ann. Otol. Rhinol. Laryngol. 100: 612 615.
16. Givon-Lavi, N.,, D. Fraser,, and R. Dagan. 2003. Vaccination of day-care center attendees reduces carriage of Streptococcus pneumoniae among their younger siblings. Pediatr. Infect. Dis. J. 22: 524 532.
17. Givon-Lavi, N.,, D. Fraser,, N. Porat,, and R. Dagan. 2002. Spread of Streptococcus pneumoniae and antibiotic-resistant S. pneumoniae from daycare center attendees to their younger siblings. J. Infect. Dis. 186: 1608 1614.
18. Gray, B. M.,, G. M. Converse III,, and H. C. Dillon, Jr. 1980. Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life. J. Infect. Dis. 142: 923 933.
19. Gray, B. M.,, G. M. Converse III,, and H. C. Dillon, Jr. 1979. Serotypes of Streptococcus pneumoniae causing disease. J. Infect. Dis. 140: 979 983.
20. Gray, B. M.,, G. M. Converse III,, N. Huhta,, R. B. Johnston, Jr.,, M. E. Pichichero,, G. Schiffman,, and H. C. Dillon, Jr. 1981. Epidemiologic studies of Streptococcus pneumoniae in infants: antibody response to nasopharyngeal carriage of types 3, 19, and 23. J. Infect. Dis. 144: 312 318.
21. Gray, B. M.,, and H. C. Dillon, Jr. 1988. Epidemiological studies of Streptococcus pneumoniae in infants: antibody to types 3, 6, 14, and 23 in the first two years of life. J. Infect. Dis. 158: 948 955.
22. Gray, B. M.,, M. E. Turner,, and H. C. Dillon, Jr. 1982. Epidemiologic studies of Streptococcus pneumoniae in infants. The effects of season and age on pneumococcal acquisition and carriage in the first 24 months of life. Am. J. Epidemiol. 116: 692 703.
23. Gwaltney, J. M., Jr., M. A. Sande, R. Austrian, and J. O. Hendley. 1975. Spread of Streptococcus pneumoniae in families. II. Relation of transfer of S. pneumoniae to incidence of colds and serum antibody. J. Infect. Dis. 132: 62 68.
24. Hansman, D.,, S. Morris,, M. Gregory,, and B. McDonald. 1985. Pneumococcal carriage amongst Australian aborigines in Alice Springs, Northern Territory. J. Hyg. 95: 677 684.
25. Heffron, R. 1939. Pneumonia. A Commonwealth Fund Book. Copyright 1939, The Commonwealth Fund. Reprinted 1979, by Harvard University Press, Cambridge, Mass..
26. Hendley, J. O.,, M. A. Sande,, P. M. Stewart,, and J. M. Gwaltney, Jr. 1975. Spread of Streptococcus pneumoniae in families. I. Carriage rates and distribution of types. J. Infect. Dis. 132: 55 61.
27. Henrichsen, J. 1995. Six newly recognized types of Streptococcus pneumoniae. J. Clin. Microbiol. 33: 2759 2762.
28. Herva, E.,, J. Luotonen,, M. Timonen,, M. Sibakov,, P. Karma,, and P. H. Makela. 1980. The effect of polyvalent pneumococcal polysaccharide vaccine on nasopharyngeal and nasal carriage of Streptococcus pneumoniae. Scand. J. Infect. Dis. 12: 97 100.
29. Huebner, R. E.,, R. Dagan,, N. Porath,, A. D. Wasas,, and K. P. Klugman. 2000. Lack of utility of serotyping multiple colonies for detection of simultaneous nasopharyngeal carriage of different pneumococcal serotypes. Pediatr. Infect. Dis. J. 19: 1017 1020.
30. Lakshman, R.,, C. Murdoch,, G. Race,, R. Burkinshaw,, L. Shaw,, and A. Finn. 2003. Pneumococcal nasopharyngeal carriage in children following heptavalent pneumococcal conjugate vaccination in infancy. Arch. Dis. Child. 88: 211 214.
31. Leino, T.,, K. Auranen,, J. Jokinen,, M. Leinonen,, P. Tervonen,, and A. K. Takala. 2001. Pneumococcal carriage in children during their first two years: important role of family exposure. Pediatr. Infect. Dis. J. 20: 1022 1027.
32. Lloyd-Evans, N.,, T. J. O’Dempsey,, I. Baldeh,, O. Secka,, E. Demba,, J. E. Todd,, T. F. McArdle,, W. S. Banya,, and B. M. Greenwood. 1996. Nasopharyngeal carriage of pneumococci in Gambian children and in their families. Pediatr. Infect. Dis. J. 15: 866 871.
33. Loda, F. A.,, A. M. Collier,, W. P. Glezen,, K. Strangert,, W. A. Clyde, Jr., and F. W. Denny. 1975. Occurrence of Diplococcus pneumoniae in the upper respiratory tract of children. J. Pediatr. 87: 1087 1093.
34. Marchisio, P.,, S. Esposito,, G. C. Schito,, A. Marchese,, R. Cavagna,, and N. Principi. 2002. Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children: implications for the use of heptavalent pneumococcal conjugate vaccine. Emerg. Infect. Dis. 8: 479 484.
35. Mbelle, N.,, R. E. Huebner,, A. D. Wasas,, A. Kimura,, I. Chang,, and K. P. Klugman. 1999. Immunogenicity and impact on nasopharyngeal carriage of a nonavalent pneumococcal conjugate vaccine. J. Infect. Dis. 180: 1171 1176.
36. McCool, T. L.,, T. R. Cate,, G. Moy,, and J. N. Weiser. 2002. The immune response to pneumococcal proteins during experimental human carriage. J. Exp. Med. 195: 359 365.
37. McCool, T. L.,, T. R. Cate,, E. I. Tuomanen,, P. Adrian,, T. J. Mitchell,, and J. N. Weiser. 2003. Serum immunoglobulin G response to candidate vaccine antigens during experimental human pneumococcal colonization. Infect. Immun. 71: 5724 5732.
38. McGee, L.,, L. McDougal,, J. Zhou,, B. G. Spratt,, F. C. Tenover,, R. George,, R. Hakenbeck,, W. Hryniewicz,, J. C. Lefevre,, A. Tomasz,, and K. P. Klugman. 2001. Nomenclature of major antimicrobial-resistant clones of Streptococcus pneumoniae defined by the pneumococcal molecular epidemiology network. J. Clin. Microbiol. 39: 2565 2571.
39. Montgomery, J. M.,, D. Lehmann,, T. Smith,, A. Michael,, B. Joseph,, T. Lupiwa,, C. Coakley,, V. Spooner,, B. Best,, and I. D. Riley. 1990. Bacterial colonization of the upper respiratory tract and its association with acute lower respiratory tract infections in Highland children of Papua New Guinea. Rev. Infect. Dis. 12( Suppl. 8): S1006 S1016.
40. Norris, C. F.,, S. R. Mahannah,, K. Smith- Whitley,, K. Ohene-Frempong,, and K. L. McGowan. 1996. Pneumococcal colonization in children with sickle cell disease. J. Pediatr. 129: 821 827.
41. Obaro, S. K.,, R. A. Adegbola,, W. A. Banya,, and B. M. Greenwood. 1996. Carriage of pneumococci after pneumococcal vaccination. Lancet 348: 271 272.
42. O’Brien, K. L.,, and H. Nohynek. 2003. Report from a WHO Working Group: standard method for detecting upper respiratory carriage of Streptococcus pneumoniae. Pediatr. Infect. Dis. J. 22: e1 e11.
43. Pasteur, L. 1881. Sur une maladie nouvelle, provoqué par la salive d’un enfant mort de la rage. C. R. Acad. Sci. 92: 159.
44. Rapola, S.,, V. Jantti,, R. Haikala,, R. Syrjanen,, G. M. Carlone,, J. S. Sampson,, D. E. Briles,, J. C. Paton,, A. K. Takala,, T. M. Kilpi,, and H. Kayhty. 2000. Natural develop- ment of antibodies to pneumococcal surface protein A, pneumococcal surface adhesin A, and pneumolysin in relation to pneumococcal carriage and acute otitis media. J. Infect. Dis. 182: 1146 1152.
45. Regev-Yochay, G.,, M. Raz,, B. Shainberg,, R. Dagan,, M. Varon,, M. Dushenat,, and E. Rubinstein. 2003. Independent risk factors for carriage of penicillin-non-susceptible Streptococcus pneumoniae. Scand. J. Infect. Dis. 35: 219 222.
46. Simell, B.,, T. M. Kilpi,, and H. Kayhty. 2002. Pneumococcal carriage and otitis media induce salivary antibodies to pneumococcal capsular polysaccharides in children. J. Infect. Dis. 186: 1106 1114.
47. Simell, B.,, M. Korkeila,, H. Pursiainen,, T. M. Kilpi,, and H. Kayhty. 2001. Pneumococcal carriage and otitis media induce salivary antibodies to pneumococcal surface adhesin a, pneumolysin, and pneumococcal surface protein a in children. J. Infect. Dis. 183: 887 896.
48. Smith, T.,, D. Lehmann,, J. Montgomery,, M. Gratten,, I. D. Riley,, and M. P. Alpers. 1993. Acquisition and invasiveness of different serotypes of Streptococcus pneumoniae in young children. Epidemiol. Infect. 111: 27 39.
49. Soewignjo, S.,, B. D. Gessner,, A. Sutanto,, M. Steinhoff,, M. Prijanto,, C. Nelson,, A. Widjaya,, and S. Arjoso. 2001. Streptococcus pneumoniae nasopharyngeal carriage prevalence, serotype distribution, and resistance patterns among children on Lombok Island, Indonesia. Clin. Infect. Dis. 32: 1039 1043.
50. Soininen, A.,, H. Pursiainen,, T. Kilpi,, and H. Kayhty. 2001. Natural development of antibodies to pneumococcal capsular polysaccharides depends on the serotype: association with pneumococcal carriage and acute otitis media in young children. J. Infect. Dis. 184: 569 576.
51. Sternberg, G. 1881. A fatal form of septicaemia in the rabbit, produced by subcutaneous injection of human saliva; an experimental research. National Board of Health annual report, 1882. Government Printing Office, Washington, D.C..
52. Sung, R. Y.,, J. M. Ling,, S. M. Fung,, S. J. Oppenheimer,, D. W. Crook,, J. T. Lau,, and A. F. Cheng. 1995. Carriage of Haemophilus influenzae and Streptococcus pneumoniae in healthy Chinese and Vietnamese children in Hong Kong. Acta Paediatr. 84: 1262 1267.
53. Syrjanen, R. K.,, T. M. Kilpi,, T. H. Kaijalainen,, E. E. Herva,, and A. K. Takala. 2001. Nasopharyngeal carriage of Streptococcus pneumoniae in Finnish children younger than 2 years old. J. Infect. Dis. 184: 451 459.
54. Syrogiannopoulos, G. A.,, G. D. Katopodis,, I. N. Grivea,, and N. G. Beratis. 2002. Antimicrobial use and serotype distribution of nasopharyngeal Streptococcus pneumoniae isolates recovered from Greek children younger than 2 years old. Clin. Infect. Dis. 35: 1174 1182.
55. Vives, M.,, M. E. Garcia,, P. Saenz,, M. A. Mora,, L. Mata,, H. Sabharwal,, and C. Svanborg. 1997. Nasopharyngeal colonization in Costa Rican children during the first year of life. Pediatr. Infect. Dis. J. 16: 852 858.
56. Whatmore, A. M.,, S. J. King,, N. C. Doherty,, D. Sturgeon,, N. Chanter,, and C. G. Dowson. 1999. Molecular characterization of equine isolates of Streptococcus pneumoniae: natural disruption of genes encoding the virulence factors pneumolysin and autolysin. Infect. Immun. 67: 2776 2782.
57. Yagupsky, P.,, N. Porat,, D. Fraser,, F. Prajgrod,, M. Merires,, L. McGee,, K. P. Klugman,, and R. Dagan. 1998. Acquisition, carriage, and transmission of pneumococci with decreased antibiotic susceptibility in young children attending a day care facility in southern Israel. J. Infect. Dis. 177: 1003 1012.
58. Yeh, S. H.,, K. M. Zangwill,, H. Lee,, S. J. Chang,, V. I. Wong,, D. P. Greenberg,, and J. I. Ward. 2003. Heptavalent pneumococcal vaccine conjugated to outer membrane protein of Neisseria meningitidis serogroup b and nasopharyngeal carriage of Streptococcus pneumoniae in infants. Vaccine 21: 2627 2631.
59. Zenni, M. K.,, S. H. Cheatham,, J. M. Thompson,, G. W. Reed,, A. B. Batson,, P. S. Palmer,, K. L. Holland,, and K. M. Edwards. 1995. Streptococcus pneumoniae colonization in the young child: association with otitis media and resistance to penicillin. J. Pediatr. 127: 533 537.

Tables

Generic image for table
TABLE 1

Rank order of serogroups of from five carriage studies

Citation: Crook D, Brueggemann A, Peto T, Sleeman K. 2004. Pneumococcal Carriage, p 136-147. In Tuomanen E, Mitchell T, Morrison D, Spratt B (ed), The Pneumococcus. ASM Press, Washington, DC. doi: 10.1128/9781555816537.ch9

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