449. The Association between Respiratory Viruses (RV) Infection and Pneumococcal (Pnc) Colonization in Children with Community-Acquired Alveolar Pneumonia (CAAP)
Session: Poster Abstract Session: Pneumococcal Vaccine in Children and Adults
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • RSV and PNC carriage pdf POSTER IDSA.pdf (2.9 MB)
  • Background: Relative high virulence was attributed to some Pnc serotypes in association with invasive disease and in acute otitis media and CAAP (Dagan, JID 2013, Shouval, PIDJ 2006, Brueggemann, JID 2004, Greenberg, PIDJ 2011). In this study we attempted to determine whether the more virulent and the less virulent Pnc serotypes are equally associated with concomitant RV infections.

    Methods: NP Pnc cultures and NP wash samples for RV were obtained prospectively (2003-2013) from hospitalized children <60 months old, with radiographically confirmed CAAP. We analyzed children with positive vs. negative results for the most common RVs (RSV, Parainfluenza, influenza, and hMPV, grouped). We excluded children with adenoviruses and coronaviruses since they were relatively rare, and rhinoviruses since these were tested in only the minority of the children. Odds ratios (OR's) and 95% confidence intervals were calculated for total NP colonization rates and  proportions of serotype-specific Pnc comparing RV (+) CAAP vs. RV (-) CAAP, adjusting for age, season and ethnic group.  Pneumonia-associated virulent serotypes (1, 5,7F, 9V, 14, 19A, 22F) were compared to the 3 most commonly found serotypes not associated with pneumonia, previously found of lesser virulence (“Non pneumonia-associated serotypes” 6A, 6B, 35B).

    Results: Total Pnc carriage rates were 508/783 (64.9%) and 353/619 (57.0%) in RV (-) and RV (+) CAAP, respectively (OR= 1.39; 1.12-1.73). Colonization with pneumonia-associated serotypes was significantly lower in RV (+) vs. RV (-) CAAP, while “Non-pneumonia-associated serotypes” colonization was similar in both groups (Figure).

    Conclusion:   An inverse relationship between nasopharyngeal carriage of the relative virulent pneumonia-associated serotypes and RV CAAP was found.  These findings suggest that the more virulent  Pnc strains may be less virus-dependent in causing CAAP.

    Description: M:\DAGAN FILES\DAGAN 2013\ABSTRACTS 2013\IDSA 2013 Figure Dudi jpeg.jpg

     

    David Greenberg, MD, Noga Givon-Lavi, PhD, Yaniv Fainguelernt, Shalom Ben-Shimol, MD, Yonat Shemer, PhD and Ron Dagan, MD, Ben-Gurion Univ of the Negev and Soroka Univ Med Ctr, Beer-Sheva, Israel

    Disclosures:

    D. Greenberg, None

    N. Givon-Lavi, None

    Y. Fainguelernt, None

    S. Ben-Shimol, None

    Y. Shemer, None

    R. Dagan, None

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