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Carriage of Haemophilus influenzae is associated with pneumococcal vaccination in Italian children.
Vaccine. 2015 Aug 26; 33(36):4559-64.V

Abstract

BACKGROUND

The pneumococcal population changes observed after the implementation of children immunization with pneumococcal conjugative vaccines (PCV) might have affected the composition of the microbial flora inhabiting the same ecological niche of Streptococcus pneumoniae. The aim of this study was to investigate the effect of PCV immunization, (PCV7 or PCV13), on S. pneumoniae and Haemophilus influenzae colonization in young children in Italy.

METHODS

Nasopharyngeal swabs were obtained from 301 children under 6 years of age (vaccinated or unvaccinated with PCV) during the period January-April 2012. Presence of S. pneumoniae and H. influenzae was investigated using conventional cultural methods. S. pneumoniae isolates were serotyped by the Quellung reaction; capsular type of H. influenzae isolates was determined by PCR. The pattern of associations between the two species and potential risk factors were investigated by a Structural Equation Modelling (SEM) analysis.

RESULTS

The prevalence of carriage was 31.56% and 43.18% for S. pneumoniae and H. influenzae, respectively. The majority of S. pneumoniae isolates belonged to non vaccine serotypes (non PCV13-types 81.1%) while H. influenzae isolates were all non-typeable. SEM analysis revealed a synergistic association between S. pneumoniae and H. influenzae colonization (rho: 0.27; 95%CI: 0.09-0.46; p=0.004). In addition, children vaccinated with PCV, either with PCV7 (coef 0.43; 95%CI: 0.07-0.79; p=0.021) or with PCV13 (coef: 0.45; 95%CI: 0.08-0.82; p=0.018), were more likely to be colonized by H. influenzae.

CONCLUSIONS

Pneumococcal vaccination increased H. influenzae nasopharyngeal carriage in children. This result highlights that an indirect effect of PCV vaccination can be perturbation of the nasopharyngeal flora. In the era of higher-valent pneumococcal vaccines, surveillance of carriage is crucial to monitor alterations in the bacterial ecosystem, thus preventing possible clinical problems.

Authors+Show Affiliations

Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.Unit of Microbiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.Unit of Microbiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy. Electronic address: annalisa.pantosti@iss.it.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26190092

Citation

Camilli, Romina, et al. "Carriage of Haemophilus Influenzae Is Associated With Pneumococcal Vaccination in Italian Children." Vaccine, vol. 33, no. 36, 2015, pp. 4559-64.
Camilli R, Vescio MF, Giufrè M, et al. Carriage of Haemophilus influenzae is associated with pneumococcal vaccination in Italian children. Vaccine. 2015;33(36):4559-64.
Camilli, R., Vescio, M. F., Giufrè, M., Daprai, L., Garlaschi, M. L., Cerquetti, M., & Pantosti, A. (2015). Carriage of Haemophilus influenzae is associated with pneumococcal vaccination in Italian children. Vaccine, 33(36), 4559-64. https://doi.org/10.1016/j.vaccine.2015.07.009
Camilli R, et al. Carriage of Haemophilus Influenzae Is Associated With Pneumococcal Vaccination in Italian Children. Vaccine. 2015 Aug 26;33(36):4559-64. PubMed PMID: 26190092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carriage of Haemophilus influenzae is associated with pneumococcal vaccination in Italian children. AU - Camilli,Romina, AU - Vescio,Maria Fenicia, AU - Giufrè,Maria, AU - Daprai,Laura, AU - Garlaschi,Maria Laura, AU - Cerquetti,Marina, AU - Pantosti,Annalisa, Y1 - 2015/07/16/ PY - 2015/02/23/received PY - 2015/06/23/revised PY - 2015/07/06/accepted PY - 2015/7/21/entrez PY - 2015/7/21/pubmed PY - 2016/5/19/medline KW - Haemophilus influenzae KW - Nasopharyngeal carriage KW - PCV13 KW - PCV7 KW - Streptococcus pneumoniae SP - 4559 EP - 64 JF - Vaccine JO - Vaccine VL - 33 IS - 36 N2 - BACKGROUND: The pneumococcal population changes observed after the implementation of children immunization with pneumococcal conjugative vaccines (PCV) might have affected the composition of the microbial flora inhabiting the same ecological niche of Streptococcus pneumoniae. The aim of this study was to investigate the effect of PCV immunization, (PCV7 or PCV13), on S. pneumoniae and Haemophilus influenzae colonization in young children in Italy. METHODS: Nasopharyngeal swabs were obtained from 301 children under 6 years of age (vaccinated or unvaccinated with PCV) during the period January-April 2012. Presence of S. pneumoniae and H. influenzae was investigated using conventional cultural methods. S. pneumoniae isolates were serotyped by the Quellung reaction; capsular type of H. influenzae isolates was determined by PCR. The pattern of associations between the two species and potential risk factors were investigated by a Structural Equation Modelling (SEM) analysis. RESULTS: The prevalence of carriage was 31.56% and 43.18% for S. pneumoniae and H. influenzae, respectively. The majority of S. pneumoniae isolates belonged to non vaccine serotypes (non PCV13-types 81.1%) while H. influenzae isolates were all non-typeable. SEM analysis revealed a synergistic association between S. pneumoniae and H. influenzae colonization (rho: 0.27; 95%CI: 0.09-0.46; p=0.004). In addition, children vaccinated with PCV, either with PCV7 (coef 0.43; 95%CI: 0.07-0.79; p=0.021) or with PCV13 (coef: 0.45; 95%CI: 0.08-0.82; p=0.018), were more likely to be colonized by H. influenzae. CONCLUSIONS: Pneumococcal vaccination increased H. influenzae nasopharyngeal carriage in children. This result highlights that an indirect effect of PCV vaccination can be perturbation of the nasopharyngeal flora. In the era of higher-valent pneumococcal vaccines, surveillance of carriage is crucial to monitor alterations in the bacterial ecosystem, thus preventing possible clinical problems. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/26190092/Carriage_of_Haemophilus_influenzae_is_associated_with_pneumococcal_vaccination_in_Italian_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00937-8 DB - PRIME DP - Unbound Medicine ER -