Epidemiology of nasopharyngeal carriage of respiratory bacterial pathogens in children and adults: cross-sectional surveys in a population with high rates of pneumococcal disease

BMC Infectious Diseases

Research Article

Amanda J Leach¹  Janelle Fisher¹  Jonathan R Carapetis¹  Grant A Mackenzie²  Peter S Morris³ 

[1] Child Health Division, Menzies School of Health Research, Darwin, Australia;Charles Darwin University, Darwin, Australia;Child Health Division, Menzies School of Health Research, Darwin, Australia;Flinders University, School of Medicine, Adelaide, Australia;Charles Darwin University, Darwin, Australia;Child Health Division, Menzies School of Health Research, Darwin, Australia;Flinders University, School of Medicine, Adelaide, Australia;Charles Darwin University, Darwin, Australia;NT Clinical School, Flinders University, Darwin, Australia;

关键词: Invasive Pneumococcal Disease;    Pneumococcal Conjugate Vaccine;    Northern Territory;    Moraxella Catarrhalis;    Pneumococcal Serotypes;   

DOI  :  10.1186/1471-2334-10-304

 received in 2010-06-24, accepted in 2010-10-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundTo determine the prevalence of carriage of respiratory bacterial pathogens, and the risk factors for and serotype distribution of pneumococcal carriage in an Australian Aboriginal population.MethodsSurveys of nasopharyngeal carriage of Streptococcus pneumoniae, non-typeable Haemophilus influenzae, and Moraxella catarrhalis were conducted among adults (≥16 years) and children (2 to 15 years) in four rural communities in 2002 and 2004. Infant seven-valent pneumococcal conjugate vaccine (7PCV) with booster 23-valent pneumococcal polysaccharide vaccine was introduced in 2001. Standard microbiological methods were used.ResultsAt the time of the 2002 survey, 94% of eligible children had received catch-up pneumococcal vaccination. 324 adults (538 examinations) and 218 children (350 examinations) were enrolled. Pneumococcal carriage prevalence was 26% (95% CI, 22-30) among adults and 67% (95% CI, 62-72) among children. Carriage of non-typeable H. influenzae among adults and children was 23% (95% CI, 19-27) and 57% (95% CI, 52-63) respectively and for M. catarrhalis, 17% (95% CI, 14-21) and 74% (95% CI, 69-78) respectively. Adult pneumococcal carriage was associated with increasing age (p = 0.0005 test of trend), concurrent carriage of non-typeable H. influenzae (Odds ratio [OR] 6.74; 95% CI, 4.06-11.2) or M. catarrhalis (OR 3.27; 95% CI, 1.97-5.45), male sex (OR 2.21; 95% CI, 1.31-3.73), rhinorrhoea (OR 1.66; 95% CI, 1.05-2.64), and frequent exposure to outside fires (OR 6.89; 95% CI, 1.87-25.4). Among children, pneumococcal carriage was associated with decreasing age (p < 0.0001 test of trend), and carriage of non-typeable H. influenzae (OR 9.34; 95% CI, 4.71-18.5) or M. catarrhalis (OR 2.67; 95% CI, 1.34-5.33). Excluding an outbreak of serotype 1 in children, the percentages of serotypes included in 7, 10, and 13PCV were 23%, 23%, and 29% (adults) and 22%, 24%, and 40% (2-15 years). Dominance of serotype 16F, and persistent 19F and 6B carriage three years after initiation of 7PCV is noteworthy.ConclusionsPopulation-based carriage of S. pneumoniae, non-typeable H. influenzae, and M. catarrhalis was high in this Australian Aboriginal population. Reducing smoke exposure may reduce pneumococcal carriage. The indirect effects of 10 or 13PCV, above those of 7PCV, among adults in this population may be limited.

【 授权许可】

CC BY   
© Mackenzie et al; licensee BioMed Central Ltd. 2010