title: Streptococcus pneumoniae colonization among patients with human immunodeficiency virus-1 who had received 23-valent polysaccharide pneumococcal vaccine.
abstract: OBJECTIVE
  To evaluate the impact of 23-valent polysaccharide pneumococcal vaccine on Streptococcus pneumoniae colonization in the upper airway of patients with human immunodeficiency virus (HIV)-1 in Taiwan.
  
  
  METHODS
  302 HIV-infected patients aged 15 years or older underwent swab cultures of the posterior pharynx and tonsils for S. pneumoniae between June 1, 2000 and June 30, 2002. 198 patients (65.6%) had received 23-valent polysaccharide pneumococcal vaccine with a median interval of 420 days (range, 27-634 days) before cultures were performed. Clinical characteristics and laboratory findings were analyzed to determine the factors associated with S. pneumoniae colonization in the upper airway.
  
  
  RESULTS
  Twenty patients (6.6%) had colonization with S. pneumoniae: 15 of 198 patients (7.6%) who had received 23-valent polysaccharide pneumococcal vaccine and 5 of 104 patients (4.8%) who had not received the vaccine (p = 0.37). According to the multivariate analysis, smoking was the only factor that was statistically significantly associated with S. pneumoniae colonization (adjusted odds ratio, 4.03; 95% confidence interval, 1.04-15.64; p = 0.04); pneumococcal vaccination was not statistically significantly associated with S. pneumoniae colonization.
  
  
  CONCLUSIONS
  Among HIV-infected patients, smoking was the only factor significantly associated with a higher prevalence of upper airway colonization by S. pneumoniae. As previous receipt of 23-valent polysaccharide pneumococcal vaccine was not associated with a lower prevalence of S. pneumoniae colonization, a better vaccination strategy, in addition to smoking cessation, may be needed to reduce S. pneumoniae colonization in HIV-infected adults.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Lo
authors.forename: Tsai-Ling
authors.initials: TL
authors.lastname: Lauderdale
authors.forename: Sui-Yuan
authors.initials: SY
authors.lastname: Chang
authors.forename: Chin-Fu
authors.initials: CF
authors.lastname: Hsiao
authors.forename: Chien-Ching
authors.initials: CC
authors.lastname: Hung
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000382:microbiology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000382:microbiology*; D015497:HIV-1 / Q000254:growth & development*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011008:Pneumococcal Infections / Q000382:microbiology / Q000517:prevention & control* / Q000821:virology*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D012907:Smoking; D013296:Streptococcus pneumoniae / Q000254:growth & development / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines