Related Experiment Video
Updated: Aug 9, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Pneumococcal coinfection with human metapneumovirus
Shabir A Madhi1, Herbert Ludewick, Locadiah Kuwanda
1University of the Witwatersrand/Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Bertsham, South Africa. madhis@hivsa.com
Background:
Infection with the newly discovered human metapneumovirus (hMPV) may lead to hospitalization of children with lower respiratory tract infection (LRTI), although the pathogenesis thereof remains to be elucidated.
Methods:
This hypothesis-generating study involved a cohort of children randomized to receive 9-valent conjugate pneumococcal vaccine or placebo and who were tested for hMPV infection when hospitalized for LRTI. By use of a nested reverse-transcription polymerase chain reaction assay targeted at amplifying a fragment of the hMPV fusion (F) protein gene, 202 such infections were identified among 2715 episodes of LRTI in children.
Results:
Among human immunodeficiency virus (HIV)-uninfected children who had received 3 doses of conjugate pneumococcal vaccine, the incidence of hMPV-associated LRTI was reduced by 45% (95% confidence interval [CI], 19%-62%; P = .002), and the incidence of clinical pneumonia was reduced by 55% (95% CI, 22%-74%; P = .003). Similarly, in fully vaccinated HIV-infected children, the incidence of hMPV-associated LRTI was reduced by 53% (95% CI, 3%-77%; P = .035), and that of clinical pneumonia was reduced by 65% (95% CI, 19%-85%; P = .020).
Conclusions:
The pathogenesis of hMPV-associated LRTI that results in hospitalization of both HIV-infected and -uninfected children involves bacterial coinfection with pneumococcus, and a significant proportion of these hospitalizations may be prevented by vaccination with pneumococcal conjugate vaccine.
Insights
Pneumococcal conjugate vaccine significantly reduces human metapneumovirus (hMPV)-associated lower respiratory tract infections and pneumonia in hospitalized children. Vaccination may prevent a substantial number of hMPV hospitalizations, highlighting the role of bacterial coinfection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Vaccinology
Background:
- Human metapneumovirus (hMPV) is a newly discovered virus causing lower respiratory tract infections (LRTI) in children.
- The pathogenesis of hMPV-associated LRTI leading to hospitalization remains unclear.
- Bacterial coinfection is suspected in hMPV pathogenesis.
Purpose of the Study:
- To investigate the role of bacterial coinfection in hMPV-associated LRTI.
- To determine if pneumococcal conjugate vaccine (PCV) can prevent hMPV-associated LRTI and pneumonia.
- To evaluate the efficacy of PCV in both HIV-uninfected and HIV-infected children.
Main Methods:
- A cohort study involving children hospitalized with LRTI.
- Participants were randomized to receive 9-valent conjugate pneumococcal vaccine or placebo.
- hMPV infection was detected using a nested reverse-transcription polymerase chain reaction assay targeting the F protein gene.
Main Results:
- Among HIV-uninfected children receiving PCV, hMPV-associated LRTI incidence decreased by 45% (P = .002) and pneumonia by 55% (P = .003).
- In fully vaccinated HIV-infected children, hMPV-associated LRTI incidence decreased by 53% (P = .035) and pneumonia by 65% (P = .020).
- These reductions indicate a significant protective effect of PCV against hMPV-related respiratory illness.
Conclusions:
- The pathogenesis of hMPV-associated LRTI involves bacterial coinfection with Streptococcus pneumoniae.
- Pneumococcal conjugate vaccine (PCV) significantly reduces hMPV-associated LRTI and pneumonia in hospitalized children.
- PCV vaccination can prevent a substantial proportion of hMPV-related hospitalizations in both HIV-infected and HIV-uninfected children.
Related Concept Videos
01:29Pneumonia I: Introduction
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:14Atypical Pneumonia
01:29Respiratory Syncytial Virus Disease
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:30Pneumonia III: Complications and Assessment