Nasopharyngeal pneumococcal carriage rates among HIV-infected adults following widespread pediatric use of conjugate pneumococcal vaccine-13

Abstract

Background: Nasopharyngeal pneumococcal carriage rates among HIV-infected adults has not been described since conjugate pneumococcal vaccine-13 (PCV13) was added to the universal infant and childhood vaccination schedule in 2010. Methods: HIV-infected adults presenting for routine health care visits to the Designated AIDS Center in Syracuse, NY between December 2013 and June 2015 were eligible for enrollment. Demographic, medical, and social history were recorded after obtaining informed consent. Nasopharyngeal samples were collected and cultured for the presence of Streptococcus pneumoniae using standard microbiologic techniques. Antibiotic susceptibility testing was performed using E-test!. Results: 707 nasopharyngeal samples were collected from 414 HIV-infected adults. 18 samples were culture positive for S. pneumoniae; 1 (6%) isolate was of vaccine-type, 9 (50%) were non-vaccine types, and 8 (44%) were non-typeable. The 18 isolates were recovered from 15 different patients (4% of those enrolled). Three patients were culture positive for pneumococcus isolated from 2 consecutive samples, with non-typeable pneumococci identified consecutively from 2 patients and serotype 35B identified consecutively from 1 patient. The most commonly identified non-vaccine serotypes were 35B and 15B/C. Identified pneumococci were penicillin and cefotaxime susceptible. Conclusion: Four percent of HIVinfected adults in our study population were colonized with S. pneumoniae. The non-vaccine serotypes 35B and 15B/C predominated.

Does cotrimoxazole prophylaxis in HIV patients increase the drug resistance of pneumococci? A comparative cross-sectional study in southern Ethiopia

“…The pneumococcal colonization rate (13.47%) that we had observed is also comparable to the prevalence rates, 20% and 22.% respectively reported from Malawi and Indonesia [8,26]. However, it is higher than the 3% reported from the USA, 7.3% from Ghana, and 6.4% from Kenya [30][31][32]. At the same time, two studies reported a very high pneumococcal colonization rate ie., 43.2% and 34.6%, surprisingly both from Kenya [14,38].…”

“…Secondly, nasopharyngeal pneumococcal colonization is an important reservoir and it acts as a marker for resistance among co-colonizing microflora in the upper respiratory tract of the host (e.g., H. influenzae and N. meningitides) [27][28][29]. Thirdly, a high prevalence of resistant pneumococci is identified by WHO as one of the most pressing issues [30][31][32][33]. Even conflicting reports on nasopharyngeal pneumococcal colonization are pouring in from different countries across the globe and will be elaborated later in this paper.…”

Evaluation of the Role of stat3 in Antibody and T H 17-Mediated Responses to Pneumococcal Immunization and Infection by Use of a Mouse Model of Autosomal Dominant Hyper-IgE Syndrome

“…While pneumococcal conjugate vaccines are safe and immunogenic in HIV-infected individuals, the generated antibody responses vary in functionality with ART and virologic control, tend to be less durable, and have lower efficacy in preventing invasive disease (37). Moreover, nonvaccine and nontypeable pneumococcal serotypes predominate in surveillance studies of pneumococcal carriage in HIV-infected individuals in areas of high PCV coverage (38,39), suggesting that the efficacy of PCV immunization in HIV-infected individuals may be further limited. Prior work from our group has demonstrated broad reactivity and serotype coverage of the antibody response elicited by WCV immunization in animals (40).…”