A role for Streptococcus pneumoniae in virus-associated pneumonia

Madhi, Shabir A; Klugman, Keith P; The Vaccine Trialist Group

doi:10.1038/nm1077

Cited by 565Pneumonia and Respiratory InfectionsRespiratory viral infections researchBacterial Infections and Vaccines

A role for Streptococcus pneumoniae in virus-associated pneumonia

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Madhi, Shabir A, Klugman, Keith P, The Vaccine Trialist Group·2004·Nature Medicine

DOI 10.1038/nm1077PMC PMC7095883

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Abstract

Here we show, in a double-blind, randomized, placebo-controlled trial in 37,107 fully immunized infants in Soweto, South Africa, that a 9-valent pneumococcal conjugate vaccine, PncCV, prevents 31% (95% confidence interval = 15-43%) of pneumonias associated with any of seven respiratory viruses in children in hospital. These data suggest that the pneumococcus has a major role in the development of pneumonia associated with these viruses and that viruses contribute to the pathogenesis of bacterial pneumonia.

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Children younger than 5 years can be a high-risk group for pneumonia after influenza infection, due to primary viral pneumonia or secondary bacterial pneumonia mainly associated with pneumococci.
“Children younger than 5 years can be a high-risk group for pneumonia after an influenza infection—either due to primary viral pneumonia or secondary bacterial pneumonia (mainly associated with pneumococci).86, 87”
From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [86]
Among fatal A(H1N1)pdm09 cases with autopsy specimen testing, any bacterial co-infection was identified in a mean of 23% of cases.
“Fatal cases with autopsy specimen testing were reported in 11 studies, in which any co-infection was identified in 23% of cases”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [9]
Bacterial pathogens in the respiratory tract may also predispose to influenza and other viral infection.
“Conversely, bacterial pathogens in the respiratory tract may also predispose to influenza and other viral infection [9].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [9]
Vaccination against S. pneumoniae reduces the frequency of pneumonia associated with influenza A, RSV and parainfluenza viruses.
“Madhi and colleagues demonstrated that vaccination against S. pneumoniae reduces the frequency of pneumonia associated with influenza A, RSV and parainfluenza viruses [10].”
From Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza (2009) · cites this paper as [10]
The South Africa study concluded that a significant proportion of viral pneumonia is due to bacterial co-infection and is preventable by a bacterial vaccine.
“The study concluded that a significant proportion of viral pneumonia is due to bacterial co‐infection and is preventable by a bacterial vaccine.”
From Bacterial and viral infections associated with influenza (2013) · cites this paper as [52]

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Efficacy of 9-valent \npneumococcal conjugate vaccine against radiographically-confirmed pneumonia among children before and after 24 months of age in South Africa.
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Authors: Madhi, S. A., Klugman, K. P., & The Vaccine Trialist Group
Affiliations: University of the Witwatersrand (ZA)
Emory University (US)
Corresponding author: Klugman, Keith P
ORCID: Madhi, Shabir A
Klugman, Keith P
Venue: Nature Medicine
Publisher: Springer Science and Business Media LLC
Published: 2004-07-11
Volume: 10
Issue: 8
Pages: 811-813
ISSN: 1078-8956 (ISSN-L)
1546-170X
DOI: 10.1038/nm1077
PMC: PMC7095883
OpenAlex: W2054703106
Cited by: 565
References: 12
Citations by year: 2026: 7 · 2025: 18 · 2024: 19 · 2023: 17 · 2022: 26 · 2021: 22 · 2020: 29 · 2019: 23 · 2018: 21 · 2017: 26 · 2016: 24 · 2015: 26 · 2014: 28 · 2013: 38 · 2012: 29
FWCI: 21.17
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Nature Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords: Streptococcus pneumoniae, respiratory viruses, bacterial co-infection, pediatric pneumonia, vaccine efficacy, hospitalized children
MeSH terms: Double-Blind Method, Humans, Infant, Pneumonia, Viral, Respiratory Syncytial Viruses, South Africa, Streptococcus pneumoniae, HIV Infections, Haemophilus Vaccines, Vaccines, Conjugate, Pneumococcal Vaccines

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A role for Streptococcus pneumoniae in virus-associated pneumonia

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