4.7 Article

Nasopharyngeal Pneumococcal Density during Asymptomatic Respiratory Virus Infection and Risk for Subsequent Acute Respiratory Illness

Journal

EMERGING INFECTIOUS DISEASES
Volume 25, Issue 11, Pages 2040-2047

Publisher

CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid2511.190157

Keywords

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Funding

  1. Vanderbilt University Clinical and Translational Science Award from the National Institutes of Health [UL1 RR024975-01]
  2. Pfizer [IIR WS1898786 [0887X1-4492], IIR WS2079099]
  3. Thrasher Research Fund [02832-9]
  4. Vanderbilt University Medical Center Department of Pediatrics
  5. Vanderbilt Faculty Research Scholars Program
  6. Pfizer Young Investigator in Vaccine Development award
  7. National Institutes of Health [R21AI112768-01A1, K23 AI141621-02]

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Increased nasopharyngeal pneumococcal (Streptococcus pneumoniae) colonization density has been associated with invasive pneumococcal disease, but factors that increase pneumococcal density are poorly understood. We evaluated pneumococcal densities in nasopharyngeal samples from asymptomatic young children from Peru and their association with subsequent acute respiratory illness (ARI). Total pneumococcal densities (encompassing all present serotypes) during asymptomatic periods were significantly higher when a respiratory virus was detected versus when no virus was detected (p<0.001). In adjusted analyses, increased pneumococcal density was significantly associated with the risk for a subsequent ARI (p<0.001), whereas asymptomatic viral detection alone was associated with lower risk for subsequent ARI. These findings suggest that interactions between viruses and pneumococci in the nasopharynx during asymptomatic periods might have a role in onset of subsequent ARI. The mechanisms for these interactions, along with other potentially associated host and environmental factors, and their role in ARI pathogenesis and pneumococcal transmission require further elucidation.

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