Streptococcus pneumoniae colonization among patients with human immunodeficiency virus-1 who had received 23-valent polysaccharide pneumococcal vaccine.
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.
Lo
Yi-Chun
YC
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Lauderdale
Tsai-Ling
TL
Chang
Sui-Yuan
SY
Hsiao
Chin-Fu
CF
Hung
Chien-Ching
CC
Chang
Shan-Chwen
SC
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
C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines