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Pneumococcal nasopharyngeal colonization in young South Indian infants
C L Coles1, R Kanungo, L Rahmathullah
1Department of International Health, John Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Insights
High rates of pneumococcal carriage were observed in South Indian infants during the first six months of life. This colonization may contribute to their increased risk of developing pneumonia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Streptococcus pneumoniae is a leading cause of childhood illness and death globally.
- Nasopharyngeal carriage in children indicates circulating bacterial strains within a community.
Purpose of the Study:
- To investigate the prevalence and risk factors of pneumococcal carriage in South Indian infants.
- To identify common pneumococcal serotypes in early infancy.
Main Methods:
- A cohort of 464 newborns in rural South India was recruited.
- Nasopharyngeal specimens were collected from infants at 2, 4, and 6 months of age.
- Risk factors for carriage and prevalent serotypes were analyzed.
Main Results:
- Pneumococcal carriage prevalence reached 70.2% by 6 months of age.
- Risk factors included female sex, household smoking, maternal education, and colostrum feeding at 2 months.
- Maternal night blindness was associated with increased carriage and carrying specific vaccine serotypes.
- Serogroups 6, 9, 10, 11, 14, 15, 19, 23, and 33 were most prevalent.
Conclusions:
- South Indian infants exhibit high pneumococcal carriage rates in the first six months.
- These high carriage rates may be a contributing factor to the elevated risk of pneumonia in this population.
- Findings highlight the need for targeted interventions and vaccination strategies.
Background:
Streptococcus pneumoniae is the most frequent bacterial cause of morbidity and mortality in young children. Bacteria carried in the nasopharynx of healthy children reflect the prevalent strains circulating in the community.
Methods:
We recruited 464 newborns from a rural area in South India with endemic vitamin A deficiency. Nasopharyngeal specimens were collected from each infant at ages 2, 4 and 6 months.
Results:
Fifty-four percent of study infants were colonized by age 2 months, with 64.1 and 70.2% carriage prevalence at ages 4 and 6 months, respectively. The odds of carriage at 2 months were significantly increased in female infants, infants living in a household in which 20 or more cigarettes were smoked each day, infants whose mothers had less than 1 year of schooling and infants fed colostrum. At age 4 months infants having 2 or more siblings <5 years of age were at significantly increased risk of carriage. At age 6 months none of the potential risk factors examined achieved statistical significance, but maternal night blindness increased the risk of colonization 3-fold. The odds of carrying a PncCRM197 vaccine serotype were increased among infants born to mothers who experienced night blindness during pregnancy. The most prevalent serogroups/types during the first 6 months of life were 6, 9, 10, 11, 14, 15, 19, 23 and 33, accounting for 76.7% of all serotyped isolates.
Conclusions:
South Indian infants experience high rates of pneumococcal carriage during the first 6 months of life, which may partially explain their increased risk for pneumonia.