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Published on: February 23, 2014
Pneumococcal Colonization in Children With Persistent Asthma: A Retrospective Cohort
Liset Olarte1,2, Dithi Banerjee2,3, Douglas Swanson1,2
1From the Department of Pediatrics, Children's Mercy Kansas City, Missouri.
Insights
Children with persistent asthma showed lower rates of pneumococcal colonization compared to healthy children. This finding impacts understanding of respiratory illness in pediatric asthma patients.
Area of Science:
- Pediatric respiratory health
- Infectious disease epidemiology
- Immunology
Background:
- Asthma is a common chronic condition in children.
- The impact of asthma on pneumococcal colonization is not well understood.
- Investigating this link is crucial for managing childhood respiratory illnesses.
Purpose of the Study:
- To compare pneumococcal colonization rates in children with and without persistent asthma.
- To determine the serotype distribution of pneumococcus in these children.
- To understand how asthma influences the carriage of Streptococcus pneumoniae.
Main Methods:
- Nasal samples were collected from children aged 5-18 with respiratory symptoms.
- Real-time PCR was used to detect pneumococcal colonization.
- Multiplex PCR identified pneumococcal serotypes in positive samples.
Main Results:
- Children with persistent asthma had significantly lower pneumococcal colonization rates (10%) than those without asthma (18.9%).
- The adjusted odds of colonization were lower in children with asthma (OR 0.4).
- Common serotypes included 19F, 3, and 6C/6D, with 64.4% being non-PCV13 types.
Conclusions:
- Persistent asthma is associated with reduced pneumococcal colonization in children.
- This suggests a potential protective effect of asthma or its management on pneumococcal carriage.
- Further research is needed to elucidate the mechanisms behind this observation.
Background:
Asthma is the most common chronic medical condition among children ≥5 years of age with invasive pneumococcal disease. How asthma or its management affects pneumococcal colonization is not fully understood. Our objective was to compare pneumococcal colonization rates between children with persistent asthma and children without asthma, and to characterize the pneumococcal serotype distribution.
Methods:
We used nasal mid-turbinate samples obtained per routine care from 5- to 18-year-old children with upper respiratory symptoms from November to April (respiratory seasons) of 2017 to 2018 and 2018 to 2019 in Kansas City, United States. Pneumococcal immunization status, prior antibiotic use and other clinical data were collected. Samples were tested for pneumococcal colonization by real-time polymerase chain reaction targeting lytA gene. Positive samples underwent multiplex serotype-specific polymerase chain reaction assays to determine the serotype.
Results:
Of 363 children (120 with persistent asthma and 243 without asthma), 87.6% were 5 to 10 years old, 50.1% were female and 74.1% received ≥3 doses of a pneumococcal conjugate vaccine. The pneumococcal colonization rate was lower in children with persistent asthma than in children without asthma (10% versus 18.9%, P = 0.03). The odds of colonization were lower in children with persistent asthma [OR 0.4 (95% confidence interval: 0.2-0.9)] after adjusting for demographic and clinical data. Pneumococcal serotype was confirmed in 77.6% of positive samples; 35.6% of those samples corresponded to PCV13 serotypes and 64.4% to non-PCV13 serotypes. The most common serotypes were 19F (15%), 3 (13%) and 6C/6D (11%).
Conclusions:
Children with persistent asthma had lower rates of pneumococcal colonization than children without asthma when seeking care for respiratory symptoms.
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