CoChat
Sign Up
Cited by 186Pneumonia and Respiratory InfectionsRespiratory viral infections researchMicrobial infections and disease research

High nasopharyngeal pneumococcal density, increased by viral coinfection, is associated with invasive pneumococcal pneumonia

Wolter, Nicole, Tempia, Stefano, Cohen, Cheryl, Madhi, Shabir A., Venter, Marietjie, Moyes, Jocelyn, Walaza, Sibongile, Malope-Kgokong, Babatyi +10 more·2014·Journal of Infectious Diseases
DOI 10.1093/infdis/jiu326
Open this paper in CoChat — free account

Abstract

BACKGROUND: We identified factors associated with pneumococcal colonization, high colonization density, and invasive pneumococcal pneumonia among patients hospitalized with acute lower respiratory tract infections (ALRTIs). METHODS: In 2010, 4025 cases were enrolled in surveillance in South Africa. A total of 969 of 4025 systematically selected nasopharyngeal-oropharyngeal specimens (24%) were tested for respiratory viruses and Streptococcus pneumoniae by real-time polymerase chain reaction. Of these, 749 (77%) had blood tested for S. pneumoniae. RESULTS: Pneumococcal colonization was detected in 55% of cases (534 of 969). On multivariable analysis that controlled for age and tuberculosis treatment, infection with influenza virus (adjusted odds ratio [OR], 2.2; 95% confidence interval [CI], 1.1-4.5), adenovirus (adjusted OR, 1.7; 95% CI, 1.1-2.7), rhinovirus (adjusted OR, 1.6; 95% CI, 1.1-2.3), and human immunodeficiency virus (HIV; adjusted OR, 1.6; 95% CI, 1.1-2.4) were associated with pneumococcal colonization. High colonization density was associated with respiratory virus coinfection (adjusted OR, 1.7; 95% CI, 1.1-2.6) and invasive pneumococcal pneumonia (adjusted OR, 2.3; 95% CI, 1.3-4.0), after adjustment for age and sex. Seven percent (52 of 749) had pneumococci detected in blood. On multivariable analysis among colonized cases, invasive pneumococcal pneumonia was associated with HIV (adjusted OR, 3.2; 95% CI, 1.4-7.5), influenza virus (adjusted OR, 8.2; 95% CI, 2.7-25.0), high colonization density (adjusted OR, 18.7; 95% CI, 2.3-155.1), and ≥5 days of hospitalization (adjusted OR, 3.7; 95% CI, 1.7-8.2). CONCLUSIONS: Respiratory virus infection was associated with elevated colonization density and, in turn, invasive pneumococcal pneumonia.

Integrity signals

Registry

Crossref · 10.1093/infdis/jiu326

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • One possible mechanism by which influenza and other viral infections might predispose infected hosts to secondary bacterial pneumonia is by altering the microbial composition of the upper respiratory tract, fostering enhanced growth of pathogens, and facilitating the subsequent entry of large bacterial loads into the LRT.

    “One possible mechanism by which influenza and other viral infections might predispose infected hosts to secondary bacterial pneumonia is by altering the microbial composition of the upper respiratory tract, fostering enhanced growth of pathogens, and facilitating the subsequent entry of large bacterial loads into the LRT”

    From Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. (2018) · cites this paper as [85]

  • Higher pneumococcal colonization density has been linked to respiratory virus co-infection and invasive pneumococcal pneumonia, after adjusting for age and sex.

    “Higher pneumococcal colonization density has been linked to respiratory virus co-infection and invasive pneumococcal pneumonia, after adjusting for age and sex”

    From Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. (2018) · cites this paper as [85]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Wolter, N., Tempia, S., Cohen, C., Madhi, S. A., Venter, M., Moyes, J., Walaza, S., Malope-Kgokong, B., Groome, M., du Plessis, M., Magomani, V., Pretorius, M., Hellferscee, O., Dawood, H., Kahn, K., Variava, E., Klugman, K. P., & von Gottberg, A.
Affiliations
  • National Health Laboratory Service (ZA)
  • National Research Foundation (ZA)
  • University of KwaZulu-Natal (ZA)
  • University of the Witwatersrand (ZA)
Corresponding author
Wolter, Nicole
ORCID
Venue
Journal of Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2014-06-06
Volume
210
Issue
10
Pages
1649-1657
ISSN
  • 0022-1899 (ISSN-L)
  • 1537-6613
DOI
10.1093/infdis/jiu326
OpenAlex
W2152692480
Semantic Scholar
2086e63ac0614850be0e79ea98b685e1f0844588
Cited by
186
References
46
Citations by year
2026: 6 · 2025: 15 · 2024: 9 · 2023: 10 · 2022: 17 · 2021: 20 · 2020: 16 · 2019: 16 · 2018: 24 · 2017: 23 · 2016: 18 · 2015: 9 · 2014: 2
FWCI
13.09
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
Centers for Disease Control and Prevention (5U51IP000155)
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
Streptococcus pneumoniae, pneumococcal carriage, viral coinfection, acute lower respiratory tract infection, influenza virus, HIV, adenovirus, rhinovirus, length of hospital stay, South Africa, tuberculosis treatment, risk factors, serotype 14, serotype 1
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Nasopharynx, Pneumonia, Pneumococcal, Prospective Studies, Respiratory Tract Infections, South Africa, Streptococcus pneumoniae, Virus Diseases, Viruses, Bacteremia, Young Adult, Bacterial Load, Coinfection, Real-Time Polymerase Chain Reaction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review