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Pneumococcal Carriage and Disease in Adults in England, 2011–2019: The Importance of Adults as a Reservoir for Pneumococcus in Communities

Title: Pneumococcal Carriage and Disease in Adults in England, 2011–2019: The Importance of Adults as a Reservoir for Pneumococcus in Communities
Authors: El Safadi, Dima; Hitchins, Lisa; Howard, Ashleigh; Aley, Parvinder; Bowman, Jaclyn; Bertran, Marta; Collins, Andrea; Colin-Jones, Rachel; Elterish, Filora; Fry, Norman K; Gordon, Stephen S; Gould, Kate; Hinds, Jason; Horn, Emilie; Hyder-Wright, Angela; Kandasamy, Rama; Ladhani, Shamez; Litt, David; Mitsi, Elena; Murphy, Annabel; Pollard, Andrew J; Plested, Emma; Pojar, Sherin; Ratcliffe, Helen; Robertson, Maria C; Robinson, Hannah; Snape, Matthew D; Solórzano, Carla; Voysey, Merryn; Begier, Elizabeth; Catusse, Julie; Lahuerta, Maria; Theilacker, Christian; Gessner, Bradford D; Tiley, Karen S; Ferreira, Daniela M
Contributors: Pfizer; University of Oxford; National Institute for Health and Care Research; Oxford Biomedical Research Centre; NIHR Clinical Research Network Thames Valley and South Midlands
Source: The Journal of Infectious Diseases ; volume 231, issue 1, page e17-e27 ; ISSN 0022-1899 1537-6613
Publisher Information: Oxford University Press (OUP)
Publication Year: 2024
Description: Background Pneumococcal carriage in healthy adults and its relationship to invasive pneumococcal disease (IPD) is not well understood. Methods Nasal wash samples from adults without close contact with young children (Liverpool, UK), 2011–2019, were cultured, and culture-negative samples tested by polymerase chain reaction (PCR). Pneumococcal carriage in adults 18–44 years was compared with carriage among pneumococcal conjugate vaccine–vaccinated children aged 13–48 months (nasopharyngeal swabs, Thames Valley, UK) and national IPD data, 2014–2019. Age group–specific serotype invasiveness was calculated and used with national IPD data to estimate carriage serotype distributions for ≥65 years. Results Overall, 98 isolates (97 carriers) were identified (3 solely by PCR) from 1631 ≥18 years adults (standardized carriage prevalence 6.4%). Despite different carriage and IPD serotype distributions between adults and children, serotype invasiveness was highly correlated (R = 0.9). Serotypes 3, 37, and 8 represented a higher proportion of adult carriage than expected. Predicted carriage serotype distributions for ≥65 years aligned closest with the young adult carriage serotype distribution. Conclusions Nasal wash technique is highly sensitive. For some serotypes carried by adults aged ≥65 years, other adults may be an important reservoir for transmission. Age groups such as older children should also be considered.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/infdis/jiae351
DOI: 10.1093/infdis/jiae351/58682049/jiae351.pdf
Availability: https://doi.org/10.1093/infdis/jiae351; https://academic.oup.com/jid/advance-article-pdf/doi/10.1093/infdis/jiae351/58682049/jiae351.pdf; https://academic.oup.com/jid/article-pdf/231/1/e17/58682049/jiae351.pdf
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.C22D905
Database: BASE