A Comparison of Pneumococcal Nasopharyngeal Carriage in Very Young Fijian Infants Born by Vaginal or Cesarean Delivery

Neal, Eleanor; Nguyen, Cattram; Ratu, Felisita Tupou; Matanitobua, Silivia; Dunne, Eileen M.; Reyburn, Rita; Kama, Mike; Devi, Rachel; Jenkins, Kylie; Tikoduadua, Lisi; Kado, Joseph; Rafai, Eric; Satzke, Catherine; Mulholland, E. Kim; Russell, Fiona M.

doi:10.1001/jamanetworkopen.2019.13650

Cited by 7 publications

(9 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We excluded infants who were born by caesarian delivery, and were thus unable to evaluate the effects of delivery mode on the nasopharyngeal microbiome or the risk of S. pneumoniae colonization. Interestingly, in a study of >2000 Fijian infants 5-8 weeks of age, the prevalence and density of pneumococcal colonization were higher among infants born by vaginal delivery than among infants delivered by caesarian birth [79]. Comparative analyses of microbiome composition were based on sample relative abundances, and we are thus unable to determine if the observed associations represent differences in the absolute amounts of bacterial genera or species within the nasopharynx across samples.…”

Section: Discussionmentioning

confidence: 90%

Non-diphtheriae Corynebacterium species are associated with decreased risk of pneumococcal colonization during infancy

Kelly

Plunkett

et al. 2021

The ISME Journal

View full text Add to dashboard Cite

Streptococcus pneumoniae (pneumococcus) is a leading cause of severe infections among children and adults. Interactions between commensal microbes in the upper respiratory tract and S. pneumoniae are poorly described. In this study, we sought to identify interspecies interactions that modify the risk of S. pneumoniae colonization during infancy and to describe development of the upper respiratory microbiome during infancy in a sub-Saharan African setting. We collected nasopharyngeal swabs monthly (0-6 months of age) or bimonthly (6-12 months of age) from 179 mother-infant dyads in Botswana. We used 16S ribosomal RNA gene sequencing to characterize the nasopharyngeal microbiome and identified S. pneumoniae colonization using a species-specific PCR assay. We detect S. pneumoniae colonization in 144 (80%) infants at a median age of 71 days and identify a strong negative association between the relative abundance of the bacterial genera Corynebacterium within the infant nasopharyngeal microbiome and the risk of S. pneumoniae colonization. Using in vitro cultivation experiments, we demonstrate growth inhibition of S. pneumoniae by secreted factors from strains of several Corynebacterium species isolated from these infants. Finally, we demonstrate that antibiotic exposures and the winter season are associated with a decline in the relative abundance of Corynebacterium within the nasopharyngeal microbiome, while breastfeeding is associated with an increase in the Corynebacterium relative abundance. Our findings provide novel insights into the interspecies interactions that contribute to colonization resistance to S. pneumoniae and suggest that the nasopharyngeal microbiome may be a previously unrecognized mechanism by which environmental factors influence the risk of pneumococcal infections during childhood. Moreover, this work lays the foundation for future studies seeking to use targeted manipulation of the nasopharyngeal microbiome to prevent infections caused by S. pneumoniae.

show abstract

Section: Discussionmentioning

confidence: 90%

Non-diphtheriae Corynebacterium species are associated with decreased risk of pneumococcal colonization during infancy

Kelly

Plunkett

et al. 2021

The ISME Journal

View full text Add to dashboard Cite

show abstract

“…[36,41,42] of studies from high, upper-middle, lower-middle, and low-income countries, respectively. No single risk factor was assessed for association with carriage in all studies, and some risk factors, such as prematurity [41], malnutrition or body mass index [39, 44, 46, 62], and infant mode of delivery [47,69] were assessed in one or two income classifications only.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Three studies reported ethnicity-based differences in pneumococcal carriage [67,68,100]. One study reported physical contact with toddlers aged 12-23 months [68] and vaginal mode of infant delivery [69] as positively associated with pneumococcal carriage.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Factors associated with pneumococcal nasopharyngeal carriage: A systematic review

Neal

Chan

Nguyen

et al. 2022

PLOS Glob Public Health

Self Cite

View full text Add to dashboard Cite

Pneumococcal disease is a major contributor to global childhood morbidity and mortality and is more common in low- and middle-income countries (LMICs) than in high-income countries. Pneumococcal carriage is a prerequisite for pneumococcal disease. Pneumococcal conjugate vaccine reduces vaccine-type carriage and disease. However, pneumococcal carriage and disease persist, and it is important to identify other potentially modifiable factors associated with pneumococcal carriage and determine if risk factors differ between low, middle, and high-income countries. This information may help inform pneumococcal disease prevention programs. This systematic literature review describes factors associated with pneumococcal carriage stratified by country income status and summarises pneumococcal carriage rates for included studies. We undertook a systematic search of English-language pneumococcal nasopharyngeal carriage studies up to 30th June 2021. Peer-reviewed studies reporting factors associated with overall pneumococcal nasopharyngeal carriage in healthy, community-based study populations were eligible for inclusion. Two researchers independently reviewed studies to determine eligibility. Results are presented as narrative summaries. This review is registered with PROSPERO, CRD42020186914. Eighty-two studies were included, and 46 (56%) were conducted in LMICs. There was heterogeneity in the factors assessed in each study. Factors positively associated with pneumococcal carriage in all income classification were young age, ethnicity, symptoms of respiratory tract infection, childcare attendance, living with young children, poverty, exposure to smoke, season, and co-colonisation with other pathogens. Breastfeeding and antibiotic use were protective against carriage in all income classifications. Median (interquartile range) pneumococcal carriage rates differed by income classification, ranging from 51% (19.3–70.2%), 38.5% (19.3–51.6%), 31.5% (19.0–51.0%), 28.5% (16.8–35.4%), (P = 0.005) in low-, lower-middle, upper-middle, and high-income classifications, respectively. Our findings suggest that where measured, factors associated with pneumococcal nasopharyngeal carriage are similar across income classifications, despite the highest pneumococcal carriage rates being in low-income classifications. Reducing viral transmission through vaccination and public health interventions to address social determinants of health would play an important role.

show abstract

“…This finding highlights the ongoing importance of environmental public health and improved standards of living. In a separate study, pneumococcal nasopharyngeal carriage was higher among newborns/infants born by vaginal delivery in Fiji than those born by Caesarean section, supporting the hypothesis that vertical pneumococcal transmission occurs through exposure to vaginal microbiome [ 7 ]. The fifth paper from Fiji was an earlier paper reporting the seven-valent PCV [ 11 ].…”

Section: Pcv and The Prevention Of Otitis Media And Hearing Loss Amon...mentioning

confidence: 84%

“…A literature review found seven papers investigating PCV in Pacific Island nations, with 5 from Fiji [ 7 - 11 ], one from Papua New Guinea [ 12 ], and another from Tonga [ 13 ]. Three of the papers from Fiji evaluated the effect of 10-valent PCV introduction in October 2012 and found that results were overall very positive.…”

Section: Pcv and The Prevention Of Otitis Media And Hearing Loss Amon...mentioning

confidence: 99%

ENT/Audiology Department of Samoa welcomes the introduction of the Pneumococcal Conjugate Vaccine (PCV) into the national childhood immunisation program.

et al. 2022

View full text Add to dashboard Cite

A Comparison of Pneumococcal Nasopharyngeal Carriage in Very Young Fijian Infants Born by Vaginal or Cesarean Delivery

Cited by 7 publications

References 48 publications

Non-diphtheriae Corynebacterium species are associated with decreased risk of pneumococcal colonization during infancy

Non-diphtheriae Corynebacterium species are associated with decreased risk of pneumococcal colonization during infancy

Factors associated with pneumococcal nasopharyngeal carriage: A systematic review

ENT/Audiology Department of Samoa welcomes the introduction of the Pneumococcal Conjugate Vaccine (PCV) into the national childhood immunisation program.

Contact Info

Product

Resources

About