Publication: Prevalence and clinical impact of Streptococcus pneumoniae nasopharyngeal carriage in solid organ transplant recipients
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Date
2019-08-06
Authors
Roca-Oporto, Cristina
Cebrero-Cangueiro, Tania
Gil-Marqués, María Luisa
Labrador-Herrera, Gema
Smani, Younes
González-Roncero, Francisco Manuel
Marín, Luis Miguel
Pachón, Jerónimo
Pachón-Ibáñez, María Eugenia
Cordero, Elisa
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Publisher
BioMed Central Ltd.
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Abstract
Background: S. pneumoniae is the leading cause of community-acquired pneumonia in the solid organ transplant recipient (SOTR); nevertheless, the prevalence of colonization and of the colonizing/infecting serotypes has not been studied in this population. In this context, the aim of the present study was to describe the rate, characteristics, and clinical impact of S. pneumoniae nasopharyngeal carriage.
Methods: A prospective observational cohort of Solid Organ Transplant recipients (SOTR) was held at the University Hospital Virgen del Rocío, Seville, Spain with the aim to evaluate the S. pneumoniae colonization and the serotype prevalence in SOTR. Two different pharyngeal swabs samples from 500 patients were included in two different seasonal periods winter and spring/summer. Optochin and bile solubility tests were performed for the isolation of thew strains. Antimicrobial susceptibility studies (MICs, mg/l) of levofloxacin, trimethoprim-sulfamethoxazole, penicillin, amoxicillin, cefotaxime, ceftriaxone, erythromycin, azithromycin and vancomycin for each isolate were determined by E-test strips. Capsular typing was done by sequential multiplex PCR reactions. A multivariate logistic regression analysis of factors potentially associated with pneumococcal nasopharyngeal carriage and disease was performed.
Results: Twenty-six (5.6%) and fifteen (3.2%) patients were colonized in winter and spring/summer periods, respectively. Colonized SOT recipients compared to non-colonized patients were more frequently men (79.5% vs. 63.1%, P < 0.05) and cohabitated regularly with children (59% vs. 32.2%, P < 0.001). The most prevalent serotype in both studied periods was 35B. Forty-five percent of total isolates were included in the pneumococcal vaccine PPV23. Trimethoprim-sulfamethoxazole and macrolides were the less active antibiotics. Three patients had non-bacteremic pneumococcal pneumonia, and two of them died.
Conclusions: Pneumococcal colonization in SOTR is low with the most colonizing serotypes not included in the pneumococcal vaccines.
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MeSH Terms
Medical Subject Headings::Persons::Persons::Age Groups::Adult
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Persons::Persons::Age Groups::Child
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Anatomy::Respiratory System::Pharynx::Nasopharynx
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections
Medical Subject Headings::Chemicals and Drugs::Complex Mixtures::Biological Products::Vaccines::Bacterial Vaccines::Streptococcal Vaccines::Pneumococcal Vaccines
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Phenotype
Medical Subject Headings::Geographical Locations::Geographic Locations::Europe::Spain
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Cocci::Streptococcaceae::Streptococcus::Streptococcus pneumoniae
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Persons::Persons::Age Groups::Child
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Anatomy::Respiratory System::Pharynx::Nasopharynx
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections
Medical Subject Headings::Chemicals and Drugs::Complex Mixtures::Biological Products::Vaccines::Bacterial Vaccines::Streptococcal Vaccines::Pneumococcal Vaccines
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Phenotype
Medical Subject Headings::Geographical Locations::Geographic Locations::Europe::Spain
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Cocci::Streptococcaceae::Streptococcus::Streptococcus pneumoniae
DeCS Terms
CIE Terms
Keywords
Streptococcus pneumoniae, Solid organ transplant recipients and nasopharyngeal carriage, Solid waste recipients, Recipientes de residuos sólidos, Transplant recipients, Receptores de trasplantes, Nasopharyngeal diseases, Enfermedades nasofaríngeas, Pneumococcal Infections, Infecciones neumocócicas
Citation
Roca-Oporto C, Cebrero-Cangueiro T, Gil-Marqués ML, Labrador-Herrera G, Smani Y, González-Roncero FM, et al. Prevalence and clinical impact of Streptococcus pneumoniae nasopharyngeal carriage in solid organ transplant recipients. BMC Infect Dis. 2019 Aug 6;19(1):697. doi: 10.1186/s12879-019-4321-8.