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Updated: Jan 11, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Asthma is associated with increased Streptococcus pneumoniae carriage in the upper airway: a systematic review and
Raeni Dwi Putri1, Chrysanti Murad2, Kuswandewi Mutyara3
1Master Study Program of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Background:
Asthma is a chronic respiratory condition characterized by airway inflammation and hyperreactivity. Previous studies have suggested a potential association between asthma and bacterial colonization of the upper respiratory tract. This systematic review and meta-analysis aimed to compare bacterial carriage rates, specifically focusing on Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus, among individuals with and without asthma.
Methods:
We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) in reporting this meta-analysis.
Results:
A total of 619 records were initially identified, leading to the inclusion of eight studies that met predefined inclusion criteria. The pooled prevalence rates of bacterial carriage were analyzed using a fixed-effect model. The risk of bias assessment was conducted using the Newcastle-Ottawa Scale. A total of 5,399 subjects were included, comprising 1,572 (29.11%) individuals with asthma and 3,827 (70.88%) without asthma. The prevalence of S. pneumoniae carriage was significantly higher in individuals with asthma (30.8%, 95% CI: 19.5-42.1%) compared to those without (19.2%, 95% CI: 8.3-30%) with an odds ratio (OR) of 1.35 (95% CI: 1.10-1.66, p = 0.005; I2 = 29%). In contrast, H. influenzae carriage rates were similar between groups (18.6% in individuals with asthma vs. 21.4% with no asthma; OR = 0.93, p = 0.84; I2 = 0%). The prevalence of M. catarrhalis was low in individuals with asthma (4.7%), and the data for S. aureus was limited, showing a prevalence of 36.67% among individuals with asthma compared to 26.67% with no asthma.
Conclusion:
This systematic review and meta-analysis showed that asthma may increase the risk of S. pneumoniae carriage. The similar carriage rates of H. influenzae between the two groups suggest distinct mechanisms of bacterial colonization, underscoring the need to further investigate asthma's role in predisposing individuals to specific bacterial infections.
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