Acquisition and Transmission of Streptococcus pneumoniae Are Facilitated during Rhinovirus Infection in Families with Children
Acquisition and Transmission of Streptococcus pneumoniae Are Facilitated during Rhinovirus Infection in Families with Children
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DOI：
10.1164/rccm.201702-0357oc
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发表时间：
2017-11-01
影响因子：
24.7
通讯作者：
Peltola, Ville
中科院分区：
文献类型：
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作者：
Karppinen, Sinikka;Terasjarvi, Johanna;Peltola, Ville
理论基础：实验室和临床证据表明，鼻病毒和肺炎链球菌在呼吸道感染的发病机制中存在协同作用。然而，鼻病毒是否促进肺炎球菌的感染和传播尚不清楚。目的：描述鼻病毒感染对有儿童家庭内肺炎球菌感染和传播的影响。方法：调查29个至少有两个孩子的家庭。随访开始于家庭成员出现呼吸道感染症状，包括每日症状日记和鼻拭子样本，每周两次，持续3周。父母拿了棉签，并通过邮件送到了一家学习诊所。用逆转录-聚合酶链式反应检测鼻病毒，测序分型。肺炎球菌通过抗原试验、标准培养方法、血清分型和全基因组测序进行鉴定。鼻病毒感染对肺炎球菌获得率和家庭内传播的影响根据观察到的获得性事件和未定居的人次进行评估，使用泊松回归。测量和主要结果：在发病时38名受试者(30%)和在随访期间86名受试者(67%)检测到鼻病毒。9名(7%)受试者在第一天发现肺炎链球菌，38名受试者(30%)在随访过程中检出肺炎链球菌。与未感染鼻病毒的儿童相比，鼻病毒感染的儿童从社区获得肺炎球菌的比率(95%可信区间，1.1~15.4)和家庭内传播的比率(95%可信区间，3.1~69.6)分别是4.3倍和14.8倍。
Rationale: Laboratory and clinical evidence suggests synergy between rhinoviruses and Streptococcus pneumoniae in the pathogenesis of respiratory tract infections. However, it is unclear whether rhinoviruses promote pneumococcal acquisition and transmission.Objectives: To describe the impact of rhinovirus infection on the acquisition and transmission of pneumococci within families with children.Methods: We investigated 29 families with at least two children. The follow-up started at the onset of respiratory infectious symptoms in any family member and consisted of daily symptom diary and nasal swab samples from each participant twice per week for 3 weeks. Swabs were taken by the parents and sent to a study clinic by mail. Rhinoviruses were detected by reverse transcription-polymerase chain reaction and typed by sequencing. Pneumococci were identified by an antigen test and by standard culture methods, serotyping, and whole-genome sequencing. The effect of rhinovirus infection on the rates of pneumococcal acquisition and within-family transmission was estimated from the observed acquisition events and person-times spent uncolonized, using Poisson regression.Measurements and Main Results: Rhinovirus was detected in 38 subjects (30%) at the onset and in 86 subjects (67%) during the follow-up. S. pneumoniae was detected on the first day in 9 (7%) and during follow-up in 38 (30%) subjects. Children with rhinovirus infection had a 4.3-fold rate of pneumococcal acquisition from the community (95% confidence interval, 1.1-15.4) and a 14.8-fold rate of within-family transmission (95% confidence interval, 3.1-69.6) compared with children without rhinovirus infection.Conclusions: Rhinovirus infection within families facilitates acquisition and within-family transmission of S. pneumoniae.