Upper respiratory Streptococcus pneumoniae colonization among working-age adults with prevalent exposure to overcrowding.

Autor: Parker AM; Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA., Jackson N; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Awasthi S; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Kim H; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Alwan T; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Wyllie AL; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA., Kogut K; Center for Environmental Research & Community Health, School of Public Health, University of California, Berkeley, California, USA., Holland N; Center for Environmental Research & Community Health, School of Public Health, University of California, Berkeley, California, USA., Mora AM; Center for Environmental Research & Community Health, School of Public Health, University of California, Berkeley, California, USA., Eskenazi B; Center for Environmental Research & Community Health, School of Public Health, University of California, Berkeley, California, USA., Riley LW; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Lewnard JA; Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA.; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, USA.; Center for Computational Biology, College of Engineering, University of California, Berkeley, California, USA.
Jazyk: angličtina
Zdroj: Microbiology spectrum [Microbiol Spectr] 2024 Aug 06; Vol. 12 (8), pp. e0087924. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1128/spectrum.00879-24
Abstrakt: Most pneumococcal disease occurs among infants and older adults and is thought to be driven by the transmission of Streptococcus pneumoniae from young children to these vulnerable age groups. However, pneumococcal disease outbreaks also affect non-elderly adults living or working in congregate, close-contact settings. Little is known about pneumococcal carriage in such populations. From July to November 2020, we collected saliva from low-income adult farmworkers in Monterey County, California, and tested for pneumococcal carriage following culture enrichment via quantitative PCR assays targeting the pneumococcal lytA and piaB genes. Participants were considered to carry pneumococci if lytA and piaB cycle threshold values were both below 40. Among 1,283 participants enrolled in our study, 117 (9.1%) carried pneumococci. Carriers tended more often than non-carriers to be exposed to children aged <5 years [odds ratio (OR) = 1.45 (0.95-2.20)] and overcrowding [OR = 1.48 (0.96-2.30) and 2.84 (1.20-6.73), respectively, for participants in households with >2-4 and >4 persons per bedroom vs ≤2 persons per bedroom]. Household overcrowding remained associated with increased risk of carriage among participants not exposed to children aged <5 years [OR = 2.05 (1.18-3.59) for participants living in households with >2 vs ≤2 persons per bedroom]. Exposure to children aged <5 years and overcrowding were each associated with increased pneumococcal density among carriers [ piaB c T difference of 2.04 (0.36-3.73) and 2.44 (0.80-4.11), respectively]. While exposure to young children was a predictor of pneumococcal carriage, associations of overcrowding with increased prevalence and density of carriage in households without young children suggest that transmission also occurs among adults in close-contact settings.IMPORTANCEAlthough infants and older adults are the groups most commonly affected by pneumococcal disease, outbreaks are known to occur among healthy, working-age populations exposed to overcrowding, including miners, shipyard workers, military recruits, and prisoners. Carriage of Streptococcus pneumoniae is the precursor to pneumococcal disease, and its relation to overcrowding in adult populations is poorly understood. We used molecular methods to characterize pneumococcal carriage in culture-enriched saliva samples from low-income adult farmworkers in Monterey County, CA. While exposure to children in the household was an important risk factor for pneumococcal carriage, living in an overcrowded household without young children was an independent predictor of carriage as well. Moreover, participants exposed to children or overcrowding carried pneumococci at higher density than those without such exposures, suggesting recent transmission. Our findings suggest that, in addition to transmission from young children, pneumococcal transmission may occur independently among adults in overcrowded settings.
Competing Interests: J.A.L. discloses receipt of grant funding from Pfizer, Inc. and Merck, Sharp & Dohme and consulting honoraria from Pfizer, Inc.; Merck, Sharp & Dohme; and VaxCyte, Inc. A.L.W. discloses receipt of grant funding from Pfizer, Inc.; Merck, Sharp & Dohme; SalivaDirect, Inc.; Valvi.io; and Shield T3 and consulting honoraria from Pfizer, Inc.; Merck, Sharp & Dohme; Diasorin; PPS Health; Co-Diagnostics; and Global Diagnostic Systems. All other authors declare no competing interests.
Databáze: MEDLINE
Externí odkaz: