An Epidemiologic Study of Pneumonia and Its Mode of Spread*

Rosenau, Milton J.; Felton, Lloyd D.; Atwater, Reginald M.

doi:10.1093/oxfordjournals.aje.a120022

Cited by 6 publications

(5 citation statements)

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“…Also, Rosenau et al . [32] reported a uniform 50% rate of oropharyngeal carriage in Boston, MA, amongst normal (asymptomatic) individuals independent of subjects age [32]. Since S. pneumoniae strains vary greatly in their virulence in mice [33]–[35] pneumococcal carriage is likely to be underestimated in these historic studies whereas the strains virulence would have limited effect on the current sensitivity of molecular methods.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae in Saliva of Dutch Primary School Children

et al. 2014

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While nasopharyngeal sampling is the gold standard for the detection of Streptococcus pneumoniae carriage, historically seen, saliva sampling also seems highly sensitive for pneumococcal detection. We investigated S. pneumoniae carriage in saliva from fifty schoolchildren by conventional and molecular methods. Saliva was first culture-enriched for pneumococci, after which, DNA was extracted from all bacterial growth and tested by quantitative-PCR (qPCR) for pneumococcus-specific genes lytA and piaA. Next, serotype composition of the samples was determined by serotype-specific qPCRs, conventional-PCRs (cPCR) and sequencing of cPCR amplicons. Although only 2 (4%) of 50 samples were positive by conventional diagnostic culture, 44 (88%) were positive for pneumococci by qPCR. In total, we detected the presence of at least 81 pneumococcal strains representing 20 serotypes in samples from 44 carriers with 23 carriers (52%) positive for multiple (up to 6) serotypes. The number of serotypes detected per sample correlated with pneumococcal abundance. This study shows that saliva could be used as a tool for future pneumococcal surveillance studies. Furthermore, high rates of pneumococcal carriage and co-carriage of multiple pneumococcal strains together with a large number of serotypes in circulation suggests a ubiquitous presence of S. pneumoniae in saliva of school-aged children. Our results also suggest that factors promoting pneumococcal carriage within individual hosts may weaken competitive interactions between S. pneumoniae strains.

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Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae in Saliva of Dutch Primary School Children

et al. 2014

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“…Early studies measuring pneumococcal carriage in healthy adults collected only oral samples (saliva, throat swabs, or washes) and used mouse inoculation animal models [99][100][101][102][103][104]. These studies reported pneumococcal carriage prevalence values of 21% to 94% across all ages (Figure 3) [16,[99][100][101][102][103][104], suggesting that current adult pneumococcal carriage prevalence may be underestimated if only nasopharyngeal cultures are analyzed.…”

Section: Assessment Methodologymentioning

confidence: 99%

“…Although saliva samples obtained from healthy adults and inoculated in the animal model were successfully used in early pneumococcal surveillance studies [99][100][101][102][103][104], ethical limitations exist with this approach. Currently, the main difficulty with the use of oral samples for pneumococcal detection is their polymicrobial nature, being rich in respiratory aerobic and anaerobic bacteria, including pathogenic and nonpathogenic species of Haemophilus sp, Neisseria sp, and Staphylococcus sp, and various alpha hemolytic non-pneumococcal streptococci [16,107,108].…”

Section: Sampling Location For Adult Pneumococcal Carriage: Nasopharynx Oropharynx or Salivamentioning

confidence: 99%

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Upper respiratory tract colonization withStreptococcus pneumoniaein adults

Arguedas

Trzciński

O’Brien

et al. 2020

Expert Review of Vaccines

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Introduction: Most of the current evidence regarding pneumococcal upper respiratory colonization in adults suggests that despite high disease burden, carriage prevalence is low. Contemporary studies on adult pneumococcal colonization have largely followed the pediatric approach by which samples are obtained mostly from the nasopharynx and bacterial detection is evaluated by routine culture alone. Recent evidence suggests that the "pediatric approach" may be insufficient in adults and pneumococcal detection in this population may be improved by longitudinal studies that include samples from additional respiratory sites combined with more extensive laboratory testing.Areas covered: In this article, relevant literature published in peer review journals on adult pneumococcal colonization, epidemiology, detection methods, and recommendations were reviewed. Expert opinion:Respiratory carriage of Streptococcus pneumoniae has been underestimated in adults. Contemporary pneumococcal carriage studies in adults that collect samples from alternative respiratory sites such as the oropharynx, saliva, or nasal wash; are culture-enriched for pneumococcus; and use molecular diagnostic methods designed to target two pneumococcal DNA sequences should enhance pneumococcal detection in the adult respiratory tract. This finding may have implications for the interpretation of dynamics of pneumococcal transmission and vaccination.

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“…Until the mid-20th century, pneumococcal carriage was studied by resorting to animal inoculation as the gold standard in colonization detection (Rosenau et al, 1926;Heffron, 1939;Mackenzie, 1941). These early studies investigated transmission of virulent serotypes during outbreaks of pneumococcal pneumonia in crowded settings or described pneumococcal epidemiology for the general population with the purpose of improving pneumococcal pneumonia diagnostics (Heffron, 1939).…”

Section: One Hundred Forty Years Of Pneumococcal Carriage Studiesmentioning

confidence: 99%

Streptococcus pneumoniae carriage studies in adults: Importance, challenges, and key issues to consider when using quantitative PCR-based approaches

et al. 2023

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Streptococcus pneumoniae causes significant morbidity and mortality among older adults. Detection of pneumococcal carriage is an accepted endpoint in pneumococcal conjugate vaccine studies. However, low sensitivity of culture-based approaches and nasopharyngeal samples have hampered adult S. pneumoniae carriage studies in the past. In contrast, detection of adult S. pneumoniae carriers with qPCR-based approaches can achieve high sensitivity and specificity and qPCR-based testing of oral samples improves accuracy of adult carriage detection. In this Viewpoint we outline a strategy for accurate qPCR-based testing. We recommend a dual-target approach for S. pneumoniae qPCR detection as no genetic target is universally present among or solely unique to it. Furthermore, we advise the evaluation of concordance among quantified qPCR targets to improve the accuracy of S. pneumoniae testing and qPCR-based serotyping. We do not recommend omission of qPCR-based oral sample testing as it will likely result in an underestimation of true adult carrier rates.

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An Epidemiologic Study of Pneumonia and Its Mode of Spread*

Cited by 6 publications

References 0 publications

Streptococcus pneumoniae in Saliva of Dutch Primary School Children

Streptococcus pneumoniae in Saliva of Dutch Primary School Children

Upper respiratory tract colonization withStreptococcus pneumoniaein adults

Streptococcus pneumoniae carriage studies in adults: Importance, challenges, and key issues to consider when using quantitative PCR-based approaches

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