Pneumococcal carriage among adults aged 50?years and older with co-morbidities attending medical practices in Rome,Italy |
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| Institution: | 1. Department of Infectious Diseases, Istituto Superiore di Sanità, Rome;2. Italian Federation of General Practitioners (Federazione Italiana Medici di Medicina Generale, FIMMG), Rome, Italy;1. Sheba Med Ctr., Ramat Gan, Israel;2. Tel-Aviv Med Ctr., Tel Aviv, Israel;3. Rabin Med Ctr., Petah Tikva, Israel;4. Rambam Med Ctr., Haifa, Israel;5. Meir Med Ctr., Kfar Saba, Israel;6. Barzilai Med Ctr., Ashkelon, Israel;7. Hillel Yaffe Med Ctr., Hadera, Israel;8. Assaf Harofe Med Ctr., Tsrifin, Israel;9. Rivka Ziv Med Ctr., Safed, Israel;10. Haddassah Med Ctr., Jerusalem, Israel;11. Soroka University Med Ctr., affiliated to the Ben-Gurion University of the Negev., Beersheba, Israel;1. Health Sciences Unit, Faculty of Social Sciences, University of Tampere, Finland;2. National Reference Centre for Bacterial Meningitis (NRCBM), Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland;3. Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health – National Institute of Hygiene (NIPH – NIH), Warsaw, Poland;4. Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland;1. Spanish Reference Laboratory for Pneumococci, Centro Nacional de Microbiología, Madrid, Spain;2. Microbiology Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain;3. CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain;4. Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain;5. Microbiology Department, Hospital Clínic, Barcelona, Spain;6. ISGlobal, Barcelona Ctr. Int. Health Res., Hospital Clínic – Universitat de Barcelona, Barcelona, Spain;7. Microbiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain;8. Microbiology Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain;9. Microbiology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain;10. Microbiology Department, Hospital Regional Universitario Carlos Haya, Malaga, Spain;11. Microbiology Department, H. Nuestra Señora de Valme, Sevilla, Spain;12. Microbiology Department, Hospital Universitario de La Princesa, Madrid, Spain;13. Medical Department, Pfizer, Madrid, Spain;1. Immunisation, Hepatitis and Blood Safety Department, Public Health England, London NW9 5EQ, England, United Kingdom;2. Respiratory & Vaccine Preventable Bacteria Reference Unit, Public Health England, London NW9 5EQ, England, United Kingdom;1. University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States;2. Vanderbilt University School of Medicine, Nashville, TN, United States |
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| Abstract: | BackgroundData on Streptococcus pneumoniae carriage in adults with co-morbidities are limited. In this study we estimated the pneumococcal carriage among adults with co-morbidities and evaluated socio-demographic and clinical risk factors. The potential coverage of the current pneumococcal vaccines recommended for adults (PCV13 and PPV23) was also investigated.MethodsA cross-sectional study on S. pneumoniae carriage among unvaccinated adults ≥50 years with co-morbidities, presenting with or without acute respiratory symptoms at general practitioners in Rome, Italy, between October 2015 and July 2016 was conducted. Pneumococcal carriage was investigated by both cultural and molecular methods. Socio-demographic variables and co-morbidities were evaluated by logistic models as possible risk factors for pneumococcal carriage.ResultsOut of 248 patients (median age: 73 yrs; IQR: 65–79), 12 (4.8%) and 83 (33.5%) individuals were found colonized using cultural or molecular methods, respectively. Potential risk factors for pneumococcal colonization as ascertained by molecular methods were: low level of education (adjusted OR = 3.71, 95% CI: 1.62–9.40), winter months (December-March vs other months, adjusted OR = 2.56, 95% CI: 1.29–5.14), and presence of chronic lung diseases (adjusted OR = 2.18, 95% CI: 1.15–4.16). The combination of serotype-specific multiplex RT-PCR and conventional PCR allowed to identify 22 serotypes/group of serotypes, of which the most common were: 24F/24A/24B, 12F/12A/12B/44/46, 6A/6B, 14, 15B/15C, and 22F/22A. Prevalence of pneumococcal carriage due to PCV13 serotypes and non-PCV13 serotypes was 23.6% and 67.3%, respectively. Prevalence of colonization due to PPV23 serotypes was estimated to be 54.6%.ConclusionsA high prevalence of S. pneumoniae carriage was observed among adults with co-morbidities, especially among individuals affected by chronic lung diseases. These results support vaccine strategies based on the sequential administration of PCV13 and PPV23 to control potentially invasive pneumococcal strains in adults, especially in subjects with co-morbidities. |
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| Keywords: | Carriage Adults PCV13 PPV23 Risk factors Co-morbidities |
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