The role of influenza and parainfluenza infections in nasopharyngeal pneumococcal acquisition among young children.
Open accessAbstract
BACKGROUND: Animal models suggest that influenza infection favors nasopharyngeal acquisition of pneumococci. We assessed this relationship with influenza and other respiratory viruses in young children. METHODS: A case-control study was nested within a prospective cohort study of acute respiratory illness (ARI) in Andean children <3 years of age (RESPIRA-PERU study). Weekly household visits were made to identify ARI and obtain nasal swabs for viral detection using real-time reverse-transcription polymerase chain reaction. Monthly nasopharyngeal (NP) samples were obtained to assess pneumococcal colonization. We determined whether specific respiratory viral ARI episodes occurring within the interval between NP samples increased the risk of NP acquisition of new pneumococcal serotypes. RESULTS: A total of 729 children contributed 2128 episodes of observation, including 681 pneumococcal acquisition episodes (new serotype, not detected in prior sample), 1029 nonacquisition episodes (no colonization or persistent colonization with the same serotype as the prior sample), and 418 indeterminate episodes. The risk of pneumococcal acquisition increased following influenza-ARI (adjusted odds ratio [AOR], 2.19; 95% confidence interval [CI], 1.02-4.69) and parainfluenza-ARI (AOR, 1.86; 95% CI, 1.15-3.01), when compared with episodes without ARI. Other viral infections (respiratory syncytial virus, human metapneumovirus, human rhinovirus, and adenovirus) were not associated with acquisition. CONCLUSIONS: Influenza and parainfluenza ARIs appeared to facilitate pneumococcal acquisition among young children. As acquisition increases the risk of pneumococcal diseases, these observations are pivotal in our attempts to prevent pneumococcal disease.
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Influenza infection facilitates the acquisition, colonization, and development of disease from S. pneumoniae in people of all ages.
“Many studies have shown that influenza infection facilitates the acquisition, colonization and development of disease from S. pneumoniae in people of all ages (Shrestha et al., 2013; Grijalva et al., 2014; Siegel et al., 2014).”
From Secondary bacterial infections associated with influenza pandemics (2017) · cites this paper as Grijalva et al., 2014
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“However, these factors were not measured in our study, and additional research, including other populations, is warranted to clarify this intriguing observation.”
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- Authors
- Grijalva, C. G., Griffin, M. R., Edwards, K. M., Williams, J. V., Gil, A. I., Verastegui, H., Hartinger, S. M., Vidal, J. E., Klugman, K. P., & Lanata, C. F.
- Affiliations
- Vanderbilt University (US)
- Instituto de Investigación Nutricional (PE)
- Emory University (US)
- Corresponding author
- Grijalva, Carlos G.
- ORCID
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03-12
- Volume
- 58
- Issue
- 10
- Pages
- 1369-1376
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC4001292
- OpenAlex
- W2107055559
- Cited by
- 72
- References
- 38
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 7 · 2017: 8 · 2016: 4 · 2015: 6 · 2014: 7
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vanderbilt University
- Emory University
- National Center for Research Resources (UL1RR024975)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Life Sciences › Immunology and Microbiology › Microbiology › Microbial infections and disease research
- Keywords
- nasopharyngeal carriage, influenza, acute respiratory illness, young children, pneumococcal serotypes, respiratory viruses, respiratory syncytial virus, human metapneumovirus, human rhinovirus, adenovirus, pneumococcal disease prevention
- MeSH terms
- Child, Preschool, Female, Humans, Infant, Infant, Newborn, Influenza, Human, Male, Nasopharynx, Orthomyxoviridae, Paramyxoviridae, Peru, Prospective Studies, Respiratory Tract Infections, Risk Factors, Serotyping, Streptococcus pneumoniae, Cohort Studies, Case-Control Studies, Paramyxoviridae Infections, Microbial Interactions
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