Pneumococcal colonization prevalence and density among Thai children with severe pneumonia and community controls

Piralam, Barameht; Prosperi, Christine; Thamthitiwat, Somsak; Bunthi, Charatdao; Sawatwong, Pongpun; Sangwichian, Ornuma; Higdon, Melissa M.; Watson, Nora; Knoll, Maria Deloria; Paveenkittiporn, Wantana; Chara, Chuwattana; Hurst, Cameron; Akarasewi, Pasakorn; Rhodes, Julia; Maloney, Susan A.; O’Brien, Katherine L.; Baggett, Henry C.

doi:10.1371/journal.pone.0232151

Cited by 21 publications

(30 citation statements)

References 37 publications

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“…We expect a positive correlation between observed CT values and bacterial burden, and between bacterial burden and the presence and intensity of symptoms. Indeed, such a relationship has been shown for Streptococcus pneumoniae , where NP carriage density was much higher in children with pneumococcal pneumonia compared with asymptomatic carriers ( Piralam et al, 2020 ; Deloria Knoll et al, 2017 ). As defined, our EFI uses each subject’s full set of NP samples to provide an aggregate measure of the evidence for pertussis infection in that subject, and incorporates information regarding both the number of detecting assays and the CT values for each result.…”

Section: Resultsmentioning

confidence: 75%

Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers

Gill

Gunning

MacLeod

et al. 2021

eLife

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Recent pertussis resurgence in numerous countries may be driven by asymptomatic infections. Most pertussis surveillance studies are cross-sectional and cannot distinguish asymptomatic from pre-symptomatic infections. Longitudinal surveillance could overcome this barrier, providing more information about the true burden of pertussis at the population level. Here we analyze 17,442 nasopharyngeal samples from a longitudinal cohort of 1320 Zambian mother/infant pairs. Our analysis has two elements. First, we demonstrate that the full range of IS481 qPCR CT values provides insight into pertussis epidemiology, showing concordance of low and high CT results over time, within mother/infant pairs, and in relation to symptomatology. Second, we exploit these full-range qPCR data to demonstrate a high incidence of asymptomatic pertussis, including among infants. Our results demonstrate a wider burden of pertussis infection than we anticipated in this population, and expose key limitations of threshold-based interpretation of qPCR results in infectious disease surveillance.

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Section: Resultsmentioning

confidence: 75%

Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers

Gill

Gunning

MacLeod

et al. 2021

eLife

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“…To understand the role of pneumococcal colonisation in ALRI in children from Myanmar, we also evaluated the nasopharyngeal colonisation rates using PCR and found a high positive rate (up to 45%) in the nasopharynx. Previous studies evaluating the pneumococcal nasopharyngeal colonisation have shown similar rates, with 54.5% and 62.5% in children aged 2-59 months in India (83) and aged 1-59 months in Thailand (84), respectively. Our results demonstrated that pneumococcal colonisation was common in children from Myanmar, providing the baseline colonisation rate in the early stages of the 10-valent PCV's introduction.…”

Section: Discussionmentioning

confidence: 56%

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Kamata¹,

Thein²,

Ja³

et al. 2021

Preprint

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Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major causative factors of ALRI after the introduction of bacterial conjugate vaccines. In Myanmar, ALRI is associated with high morbidity and mortality in children. However, detailed information on ALRI is currently lacking. Methods We conducted a prospective study to investigate the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The World Health Organization’s definitions of ALRI and severe ALRI were used with minor modifications. For the patients with suspected viral ALRI, a nasopharyngeal swab was obtained, and rapid tests for influenza and respiratory syncytial virus (RSV) were performed, followed by real-time PCR for the 16 respiratory viruses causing ALRI. Clinical information was extracted from the medical records. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were randomly enrolled in the study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty of breathing (73%), while the most common signs were tachypnoea (78%) and chest indrawing (67%). Sixteen potentially causative viruses were detected in 502 (88%) patients, with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected simultaneously in 221 patients (37%). Severe ALRI was diagnosed in 107 patients (19%). The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected in such cases. Conclusions Viral ALRI in children has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected, while influenza virus and RSV were the most common causes of mortality.

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“…Another study of children aged <5 years and hospitalized with pneumonia found carriage rates of 27%, whereas outpatients with influenza-like illness had a carriage rate of 60% (Levine et al, 2006). A more recent study of children aged <5 years found that the prevalence of nasopharyngeal colonization did not differ significantly between individuals with severe/very severe pneumonia and community controls (54.5% vs 62.5%, respectively; P = 0.12) (Piralam et al, 2020). It should be noted that the methods used for detecting S. pneumoniae varied among the studies considered in the present review (Lee et al, 2001;Moisi et al, 2016;Thummeepak et al, 2015;Turner et al, 2012;Levine et al, 2006;Piralam et al, 2020), and these methodological differences could have contributed to the differences in the observed carriage rates.…”

Section: Nasopharyngeal Carriagementioning

confidence: 95%

“…A study of children aged <5 years during 2006 showed that 55% of carriage isolates included PCV7 serotypes (Levine et al, 2006). More recently, a study conducted during 2012-2014 found a high percentage of nasopharyngeal isolates from children aged <5 years with severe/very severe pneumonia and community controls contained serotypes included in PCV10/PHiD-CV (70.0% and 61.8%, respectively) and PCV13 (76.7% and 67.9%) (Piralam et al, 2020). Further studies are required to obtain a more complete overview of the pneumococcal serotypes contained in carriage isolates.…”

Section: Serotyping Surveillancementioning

confidence: 99%

“…In general, surveillance data show that the most common pneumococcal serotypes circulating in Thailand across multiple age groups are included in the currently licensed PCVs (Phongsamart et al, 2014;Levine et al, 2006;Piralam et al, 2020;Song et al, 2004;Kim et al, 2012;Srifeungfung et al, 2010;Kim et al, 2020). A systematic review of pneumococcal serotype distribution studies conducted in Thailand between 1990 and 2017 showed that the predominant disease-causing pneumococcal serotypes were 6B and 23F (Hocknell et al, 2019).…”

Section: Serotyping Surveillancementioning

confidence: 99%

See 1 more Smart Citation

Pneumococcal disease in Thailand

Gamil¹,

Chokephaibulkit

Phongsamart

et al. 2021

International Journal of Infectious Diseases

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This review examines the epidemiology of pneumococcal disease, serotype prevalence, antibiotic resistance, and national vaccination recommendations in Thailand. The incidence of invasive pneumococcal disease (IPD) and annualized hospitalization rates for pneumococcal bacteremia in Thailand were highest in children aged <5 years and the elderly. The most prevalent serotype is serotype 6B, which is included in both the 10-and 13-valent pneumococcal conjugate vaccines (PCV10 [also known as PHiD-CV] and PCV13, respectively) registered in Thailand. Other common serotypes are 14, 18C, 19F, and 23F (included in both PCVs) and 6A and 19A (only included in PCV13). PCV10/PHiD-CV and PCV13 should cover 48.8%-74% and 73.2%-92% of isolates among children aged 5 years, respectively, and 40.0%-47.9% and 58.3%-60.9% of isolates among adults aged !65 years. Only PCV13 is licensed for adults in Thailand. Pneumococcal isolates were most commonly resistant to erythromycin, cefuroxime, and penicillin. Despite their demonstrated cost effectiveness and efficacy in reducing nasopharyngeal carriage and IPD, PCVs are not included in the Thai national immunization program. The serotype-specific IPD incidence in Thailand suggests that PCVs will reduce the disease burden in all age groups, but particularly in children and older adults.

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Pneumococcal colonization prevalence and density among Thai children with severe pneumonia and community controls

Cited by 21 publications

References 37 publications

Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers

Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Pneumococcal disease in Thailand

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