Streptococcus pneumoniae oropharyngeal colonization in children and adolescents with cystic fibrosis

J Cyst Fibros. 2016 May;15(3):366-71. doi: 10.1016/j.jcf.2015.05.008. Epub 2015 Jun 3.

Abstract

Background: This study was designed to evaluate Streptococcus pneumoniae (S. pneumoniae) carriage rates in patients with cystic fibrosis (CF).

Methods: An oropharyngeal swab was obtained from 212 CF children and adolescents enrolled during routine clinical visits. DNA from swabs was analyzed by real-time polymerase chain reaction.

Results: A total of 42 (19.8%) CF patients (mean age±standard deviation [SD], 12.0±3.3years) were colonized by S. pneumoniae. Carriage was more common in younger patients and tended to decline with age. Administration of systemic and/or inhaled antibiotics in the last 3months significantly correlated with a reduced carrier state [odds ratio (OR) 0.23, 95% confidence interval (CI) 0.07-0.69, and OR 0.26, 95% CI 0.08-0.77, respectively]. Vitamin D serum levels ≥30ng/mL were less common in carriers than that in non-carriers (OR 0.35; 95% CI 0.08-1.49). In both the vaccinated and unvaccinated subjects, serotypes 19F, 5, 4, and 9V were the most commonly carried serotypes.

Conclusions: S. pneumoniae carrier state of school-age children and adolescents with CF is more prevalent than previously thought, and pneumococcal conjugate vaccination administered in the first year of life does not reduce the risk of re-colonization in later childhood and adolescence.

Keywords: Cystic fibrosis; Pneumococcal carrier; Pneumococcal colonization; Pneumococcal conjugate vaccine; Pneumococcal vaccination; Streptococcus pneumoniae.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Cystic Fibrosis* / epidemiology
  • Cystic Fibrosis* / microbiology
  • Cystic Fibrosis* / therapy
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Oropharynx / microbiology*
  • Pneumococcal Infections* / diagnosis
  • Pneumococcal Infections* / drug therapy
  • Pneumococcal Infections* / prevention & control
  • Pneumococcal Vaccines / therapeutic use*
  • Serotyping / methods
  • Streptococcus pneumoniae* / classification
  • Streptococcus pneumoniae* / isolation & purification
  • Vaccination / methods
  • Vaccination / statistics & numerical data

Substances

  • Anti-Bacterial Agents
  • Pneumococcal Vaccines