Home Current Issue Previous Issues Published Ahead-of-Print Collections For Authors Journal Info
Skip Navigation LinksHome > May 2013 - Volume 32 - Issue 5 > Acquisition of Streptococcus pneumoniae in Pneumococcal Conj...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31828683a3
Original Studies

Acquisition of Streptococcus pneumoniae in Pneumococcal Conjugate Vaccine-naïve South African Children and Their Mothers

Nunes, Marta C. PhD*†; Shiri, Tinevimbo PhD*; van Niekerk, Nadia BTech*†; Cutland, Clare L. MD*†; Groome, Michelle J. MD*†; Koen, Anthonet MD*†; von Gottberg, Anne FCP†‡; de Gouveia, Linda ND, MT†‡; Klugman, Keith P. MD, PhD†§; Adrian, Peter V. PhD*†; Madhi, Shabir A. MD, PhD*†‡

Collapse Box

Abstract

Background: Pneumococcal nasopharyngeal colonization is a prerequisite to developing pneumococcal disease. We investigated the dynamics of pneumococcal colonization in perinatal HIV-unexposed and HIV-exposed children and their mothers and risk factors associated with new serotypes acquisition.

Methods: Two hundred forty-three mother–child pairs (120 HIV-infected, 123 HIV-uninfected mothers) were studied at 4.4, 7.2, 9.4, 12.3 and 16.0 months of the child’s age. Demographic data, nasopharyngeal swabs, as well as oropharyngeal swabs, from mothers were collected for pneumococcal conventional culture and serotyping by the Quellung method.

Results: The rate of new serotype acquisition during the 16 months did not differ between HIV-exposed (49.1%) and HIV-unexposed (52.0%) children, or between HIV-infected (18.9%) and HIV-uninfected (19.5%) mothers. Serotypes included in the 7-valent pneumococcal conjugate vaccine (PCV7) were acquired more often by HIV-infected (10.0%) compared with HIV-uninfected mothers (6.4%; P = 0.03). On multivariate analysis, day-care attendance (adjusted odds ratio [AOR], = 1.80, P = 0.02) and maternal pneumococcal colonization (AOR = 1.54, P = 0.01) were positively associated with pneumococcal acquisition in the child, whereas breast-feeding had a protective effect on PCV7-serotype acquisition in HIV-uninfected children. New acquisition of PCV7 and PCV13 serotypes in the mother was positively associated with colonization in the child (AOR = 2.01, P = 0.006 and AOR = 2.04, P = 0.002, respectively).

Conclusions: There is an association of acquisition of PCV7 and PCV13 serotypes between young children and their mothers. The higher prevalence of PCV7 serotype in HIV-infected mothers suggests that they may be a reservoir for transmission of these serotypes, which could delay indirect effects of PCV in settings with a high HIV burden.

© 2013 Lippincott Williams & Wilkins, Inc.

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.