Identifying transmission routes of Streptococcus pneumoniae and sources of acquisitions in high transmission communities.
Identifying transmission routes of Streptococcus pneumoniae and sources of acquisitions in high transmission communities.
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DOI：
10.1017/s095026881700125x
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发表时间：
2017-10
影响因子：
4.2
通讯作者：
Hu H
中科院分区：
文献类型：
--
作者：
Althouse BM;Hammitt LL;Grant L;Wagner BG;Reid R;Larzelere-Hinton F;Weatherholtz R;Klugman KP;Rodgers GL;O'Brien KL;Hu H
确定肺炎链球菌（SP）的传播源和宿主是肺炎球菌流行病学、传播动力学和疫苗政策的一个长期问题。在这里，我们使用血清型，以确定SP传输和收购（在同一个家庭，当地社区，县，或来源不明）在纵向队列的纳瓦霍族和白色山阿帕奇美洲印第安部落的儿童和成人。我们发现，成年人获得SP相对更多的家庭比其他年龄组，2-8岁的儿童通常获得在自己或周围的社区。特定人群的传播概率矩阵显示，家庭内的传播主要是从年长的兄弟姐妹到年幼的兄弟姐妹。在家庭外，儿童最常传染给同一年龄组的其他儿童，表现出年龄上的混合行为。我们发现幼儿和年龄较大的儿童是最参与SP的传播和收购，表明他们的作用SP流行病学的关键驱动程序。虽然婴儿携带流行率高，但与幼儿和年龄较大的儿童相比，他们在传播SP方面并不起核心作用。我们的研究结果与告知替代肺炎球菌结合疫苗给药策略和分析工作有关，以告知疫苗计划的优化，以及评估一般密切接触传播的病原体的传播动力学。
Identifying the transmission sources and reservoirs of Streptococcus pneumoniae (SP) is a long-standing question for pneumococcal epidemiology, transmission dynamics, and vaccine policy. Here we use serotype to identify SP transmission and examine acquisitions (in the same household, local community, and county, or of unidentified origin) in a longitudinal cohort of children and adults from the Navajo Nation and the White Mountain Apache American Indian Tribes. We found that adults acquire SP relatively more in the household than other age groups, and children 2–8 years old typically acquire in their own or surrounding communities. Age-specific transmission probability matrices show that transmissions within household were mostly seen from older to younger siblings. Outside the household, children most often transmit to other children in the same age group, showing age-assortative mixing behavior. We find toddlers and older children to be most involved in SP transmission and acquisition, indicating their role as key drivers of SP epidemiology. Although infants have high carriage prevalence, they do not play a central role in transmission of SP compared with toddlers and older children. Our results are relevant to inform alternative pneumococcal conjugate vaccine dosing strategies and analytic efforts to inform optimization of vaccine programs, as well as assessing the transmission dynamics of pathogens transmitted by close contact in general.