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Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine.
Vaccine. 2015 May 28; 33(23):2662-9.V

Abstract

BACKGROUND

Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age.

METHODS

HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method.

RESULTS

Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7.

CONCLUSION

Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study.

Authors+Show Affiliations

National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa. Electronic address: madhis@rmpru.co.za.Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.University of Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa.Children's Infectious Diseases Clinical Research Unit, Department of Paediatrics & Child Health, Faculty Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.Henry Jackson Foundation, Division of AIDS (HJF-DAIDS), A Division of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Contractor to NIAID, NIH, DHHS, Bethesda, MD, United States.Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.No affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25910923

Citation

Madhi, Shabir A., et al. "Longitudinal Study On Streptococcus Pneumoniae, Haemophilus Influenzae and Staphylococcus Aureus Nasopharyngeal Colonization in HIV-infected and -uninfected Infants Vaccinated With Pneumococcal Conjugate Vaccine." Vaccine, vol. 33, no. 23, 2015, pp. 2662-9.
Madhi SA, Izu A, Nunes MC, et al. Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine. Vaccine. 2015;33(23):2662-9.
Madhi, S. A., Izu, A., Nunes, M. C., Violari, A., Cotton, M. F., Jean-Philippe, P., Klugman, K. P., von Gottberg, A., van Niekerk, N., & Adrian, P. V. (2015). Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine. Vaccine, 33(23), 2662-9. https://doi.org/10.1016/j.vaccine.2015.04.024
Madhi SA, et al. Longitudinal Study On Streptococcus Pneumoniae, Haemophilus Influenzae and Staphylococcus Aureus Nasopharyngeal Colonization in HIV-infected and -uninfected Infants Vaccinated With Pneumococcal Conjugate Vaccine. Vaccine. 2015 May 28;33(23):2662-9. PubMed PMID: 25910923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine. AU - Madhi,Shabir A, AU - Izu,Alane, AU - Nunes,Marta C, AU - Violari,Avye, AU - Cotton,Mark F, AU - Jean-Philippe,Patrick, AU - Klugman,Keith P, AU - von Gottberg,Anne, AU - van Niekerk,Nadia, AU - Adrian,Peter V, AU - ,, Y1 - 2015/04/21/ PY - 2014/11/04/received PY - 2015/04/07/revised PY - 2015/04/10/accepted PY - 2015/4/26/entrez PY - 2015/4/26/pubmed PY - 2016/1/28/medline KW - Colonization KW - HIV KW - HIV exposure KW - Haemophilus influenzae KW - Pneumococcal conjugate vaccine KW - Staphylococcus aureus KW - Streptococcus pneumoniae SP - 2662 EP - 9 JF - Vaccine JO - Vaccine VL - 33 IS - 23 N2 - BACKGROUND: Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age. METHODS: HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method. RESULTS: Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7. CONCLUSION: Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25910923/Longitudinal_study_on_Streptococcus_pneumoniae_Haemophilus_influenzae_and_Staphylococcus_aureus_nasopharyngeal_colonization_in_HIV_infected_and__uninfected_infants_vaccinated_with_pneumococcal_conjugate_vaccine_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00477-6 DB - PRIME DP - Unbound Medicine ER -