Carriage of Streptococcus pneumoniae in asymptomatic,community-dwelling elderly in the Netherlands |
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Institution: | 1. Parasites and microbes, Wellcome Sanger Institute, Hinxton, UK;2. New York University School of Medicine, New York, NY, USA;3. Faculty of Medicine, School of Public Health, Imperial College London, UK;4. Department of Biostatistics, University of Oslo, 0317 Oslo, Norway;5. Department of Computer Science, Helsinki Institute for Information Technology HIIT, Espoo, Finland;6. Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru;7. Department of Microbiology, Carol Yu Centre for Infection, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China;8. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa;9. Malawi-Liverpool-Wellcome-Trust Clinical Research Programme, Blantyre, Malawi;10. NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, UK;11. WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 273 Banjul, the Gambia;12. The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;13. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, South Africa;14. Department of Science and Technology, National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, South Africa;15. Rollins School Public Health, Emory University, USA;p. Queens Research Institute, University of Edinburgh, UK;q. Division of Microbiology & Immunity, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK;r. Centers for Disease Control and Prevention, Atlanta, USA;s. Emory Global Health Institute, Atlanta, USA |
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Abstract: | Colonization of the upper respiratory tract by Streptococcus pneumoniae is considered prerequisite for pneumococcal disease. Despite high rates of pneumococcal disease in elderly, pneumococcal carriage rates are usually below 5% when detected by the conventional culture method.We assessed pneumococcal carriage in 330 asymptomatic community-dwelling elderly aged 65 years and older. While pneumococci were cultured from 25 (8%) individuals, 65 (20%) elderly were positive for the pneumococcus-specific lytA gene when tested by quantitative-PCR, increasing the overall number of carriers to 75 (22%). Significantly more oropharyngeal samples were pneumococci-positive (18% versus 10%, p < 0.001) when tested by the molecular method as compared to nasopharyngeal samples.Our findings indicate that pneumococcal carriage in elderly is higher than previously reported with up to 1 in 5 asymptomatic community-dwelling elderly positive for pneumococcal carriage, when detected by qPCR. The detection of pneumococci by conventional culture alone, greatly underestimates S. pneumoniae colonization in elderly. |
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Keywords: | Colonization Elderly Nasopharynx PCR |
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