title: Streptococcus pneumoniae colonisation in children and adolescents with asthma: impact of the heptavalent pneumococcal conjugate vaccine and evaluation of potential effect of thirteen-valent pneumococcal conjugate vaccine.
abstract: BACKGROUND
  The main aim of this study was to evaluate Streptococcus pneumoniae carriage in a group of school-aged children and adolescents with asthma because these results might indicate the theoretical risk of invasive pneumococcal disease (IPD) of such patients and the potential protective efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13).
  
  
  METHODS
  Oropharyngeal samples were obtained from 423 children with documented asthma (300 males, 70.9%), and tested for the autolysin-A-encoding (lytA) and the wzg (cpsA) gene of S. pneumoniae by means of real-time polymerase chain reaction.
  
  
  RESULTS
  S. pneumoniae was identified in the swabs of 192 subjects (45.4%): 48.4% of whom were aged <10 years, 46.9% aged 10-14 years, and 4.7% aged ≥15 years (p < 0.001). Carriage was significantly less frequent among the children who had received recent antibiotic therapy (odds ratio [OR 0.41]; 95% confidence interval [95% CI] 0.22-0.76). Multivariate analyses showed no association between carriage and vaccination status, with ORs of 1.05 (95% CI 0.70-1.58) for carriers of any pneumococcal serotype, 1.08 (95% CI 0.72-1.62) for carriers of any of the serotypes included in 7-valent pneumococcal conjugate vaccine (PCV7), and 0.76 (95% CI 0.45-1.28) for carriers of any of the six additional serotypes of PCV13. Serotypes 19 F, 4 and 9 V were the most frequently identified serotypes in vaccinated subjects.
  
  
  CONCLUSIONS
  These results showed that carriage of S. pneumoniae is relatively common in all school-aged children and adolescents with asthma, regardless of the severity of disease and the administration of PCV7 in the first years of life. This highlights the problem of the duration of the protection against colonisation provided by pneumococcal conjugate vaccine, and the importance of re-colonization by the same pneumococcal serotypes included in the previously used vaccine.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. Susanna.Esposito@unimi.it.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. terranova.leonardo@gmail.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Terranova
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. f.patria@policlinico.mi.it.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Patria
authors.affiliation: Pediatric Clinic, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy. gl.marseglia@smatteo.pv.it.
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Marseglia
authors.affiliation: Pediatric Clinic, II Naples University, Naples, Italy. michele.miraglia@unina2.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Miraglia del Giudice
authors.affiliation: Pediatric Clinic, University of Verona, Verona, Italy. alessandro.bodini@univr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bodini
authors.affiliation: Pediatric Unit, Garbagnate Hospital, Garbagnate, Italy. agmartelli@aogarbagnate.lombardia.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Martelli
authors.affiliation: Pediatric Clinic, University of Padua, Padua, Italy. baraldi@pediatria.unipd.it.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Baraldi
authors.affiliation: Allergology Unit, IRCCS Bambino Gesù Hospital, Rome, Italy. allerg@tin.it.
authors.forename: Oscar
authors.initials: O
authors.lastname: Mazzina
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. hollie1979@yahoo.it.
authors.forename: Claudia
authors.initials: C
authors.lastname: Tagliabue
authors.affiliation: Pediatric Clinic, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy. amelialicari@gmail.com.
authors.forename: Amelia
authors.initials: A
authors.lastname: Licari
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. valentina.ierardi@hotmail.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ierardi
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. mara.lelii87@gmail.com.
authors.forename: Mara
authors.initials: M
authors.lastname: Lelii
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, 20122, Italy. nicola.principi@unimi.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000276:immunology* / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D011008:Pneumococcal Infections / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000254:growth & development* / Q000302:isolation & purification / Q000502:physiology; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D018074:Vaccines, Conjugate