Influence of bacterial interactions on pneumococcal colonization of the nasopharynx

Shak, Joshua R.; Vidal, Jorge E.; Klugman, Keith P.

doi:10.1016/j.tim.2012.11.005

Cited by 131 publications

(145 citation statements)

References 103 publications

(130 reference statements)

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“…One might speculate that the decrease in diversity is caused by the outgrowth of pathogens, which predisposes to invasive infection, but this hypothesis can be tested only in a longitudinal study. Our initial working hypothesis was that commensal bacteria keep the facultative pathogens colonizing the nasopharynx in check (21). This could prevent their descent into the lungs and invasive infection.…”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal Microbiota in Healthy Children and Pneumonia Patients

et al. 2014

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bOur study is the first to compare the nasopharyngeal microbiota of pediatric pneumonia patients and control children by 454 pyrosequencing. A distinct microbiota was associated with different pneumonia etiologies. Viral pneumonia was associated with a high abundance of the operational taxonomic unit (OTU) corresponding to Moraxella lacunata. Patients with nonviral pneumonia showed high abundances of OTUs of three typical bacterial pathogens, Streptococcus pneumoniae complex, Haemophilus influenzae complex, and Moraxella catarrhalis. Patients classified as having no definitive etiology harbored microbiota particularly enriched in the H. influenzae complex. We did not observe a commensal taxon specifically associated with health. The microbiota of the healthy nasopharynx was more diverse and contained a wider range of less abundant taxa. P neumonia is the leading cause of childhood mortality worldwide, claiming 2 million lives yearly among young children (1). The etiology of pediatric pneumonia is complex and not routinely determined in clinical practice (2). Its definitive determination remains challenging (3). Clinical research shows that Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus are the leading pathogens of bacterial pneumonia (1, 4). Respiratory syncytial virus (RSV), parainfluenza, and influenza viruses are the main causes of pediatric viral pneumonia (e.g., see references 5 and 6). S. pneumoniae and H. influenzae frequently colonize the nasopharynx of young children, and the nasopharyngeal (NP) carriage of S. pneumoniae is considered key to pneumonia and other pneumococcal diseases (7). However, the mere nasopharyngeal presence of bacterial pathogens does not necessarily lead to invasive lung infection. Various mechanisms, such as competition with resident nonpathogenic microbiota, viral coinfection, or host immune factors are likely to affect the transition from nasopharyngeal colonization to pneumonia (8). The increasing accessibility of culture-independent sequencing methods has permitted microbiota description at various body sites (9), and the potential of commensal microbiota to modify the disease process is receiving increasing attention (10).Previous culture-independent studies of the nasopharyngeal microbiota of young children looked at healthy children (11) and compared the microbiota composition of healthy children and children with acute otitis media (12). In the present study, we analyzed the nasopharyngeal microbiota composition, including the presence of respiratory viruses, in pediatric pneumonia patients and matched healthy controls and looked for microbiota associations with the disease status. MATERIALS AND METHODS Patients and clinical samples.A prospective case-control study conducted in 2008 to 2009 in 3 major hospitals in Switzerland (Geneva, Lausanne, and Sion) to investigate pediatric community-acquired pneumonia etiology was described in detail elsewhere (13). Briefly, pneumonia cases were diagnosed according to the WHO criteria (14) in children 2 ...

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Section: Discussionmentioning

confidence: 99%

Nasopharyngeal Microbiota in Healthy Children and Pneumonia Patients

et al. 2014

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“…Mitis group streptococci are early colonizers of oral cavity surfaces and form the basis of many of the polymicrobial communities found in the mouth and nasopharynx (Aas et al, 2005;Kanasi et al, 2010;Shak et al, 2013;Xu et al, 2014a). Such communities may also contain C. albicans, which is carried by~40 % of the healthy adult population (Clayton & Noble, 1966), and it is suggested that synergistic interactions between C. albicans and streptococci can promote carriage as well as disease (Dutton et al, 2014;Falsetta et al, 2014;Xu et al, 2014b).…”

Section: Discussionmentioning

confidence: 99%

Streptococcus gordonii comCDE (competence) operon modulates biofilm formation with Candida albicans

et al. 2015

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“…Since vaccine-type strains were those found to be correlated with S. aureus carriage, this raised much concern that the introduction of the vaccine would indirectly cause a rise in S. aureus carriage and infection. 7,11,14,15 The idea that external interventions in ecosystems could damage the natural equilibrium by eliminating a less virulent 'predator' and result in undesirable emergence of a possibly more virulent 'prey' is not new and was shown decades ago for pests and pesticides. 74 The clinical trial that first suggested interference between S. pneumoniae and S. aureus found a rise in S. aureus otitis media cases following vaccination with PCV7 compared to a non-vaccinated group.…”

Section: Clinical Implications Of the Pcv Effect On Thementioning

confidence: 99%

“…This finding, together with an earlier clinical trial that reported increased S. aureus otitis media following PCV vaccination, 13 raised much concern 3,7,14,15 ; if S. pneumoniae carriage protects from S. aureus carriage and the introduction of the pneumococcal conjugate vaccines (PCV) results in decreased S. pneumoniae carriage, this could potentially lead to an increase in S. aureus carriage, and infection. In this review, we summarize the various suggested mechanisms of this inverse correlation, and the clinical implications reported following PCV introduction to date in various geographical regions.…”

Section: Introductionmentioning

confidence: 99%