Grijalva CG. Clin Infect Dis. 2014;doi:10.1093/cid/ciu148.
March 21, 2014
Pneumococcal acquisition among young children seems to be facilitated by influenza and parainfluenza acute respiratory illness, according to recent study findings published in Clinical Infectious Diseases.
Marie R. Griffin, MD, MPH, a professor of medicine and health policy, department of health policy at Vanderbilt University School of Medicine, and colleagues conducted a trial to evaluate the potential link between certain acute respiratory infections and Streptococcal pneumoniae serotypes.
The researchers evaluated 729 children aged younger than 3 years to determine if specific viral respiratory infections that occurred during the interval between nasopharyngeal samples increased the risk of nasopharyngeal acquisition of new pneumococcal serotypes.
Overall, there were 2,128 observation episodes and median duration between each was 28 days. Thirty-two percent of the observation episodes were acquisition episodes, 48% were non-acquisition episodes and 20% were indeterminate.
The most frequently identified pneumococcal serotypes were 23F, 19F, 6B, 6C, 11A and 10A among acquisition episodes.
Exposure to parainfluenza virus and influenza acute respiratory infection was more likely to increase the risk of a new pneumococcal serotype (adjusted OR=2.19; 95% CI, 1.02-4.69) compared with no acute respiratory infection exposure (adjusted OR=1.86; 95% CI, 1.15-3.01).
Acquisition of a new pneumococcal serotype among children who were already colonized was strongly associated with influenza and parainfluenza virus. However, among children who were not initially colonized, no strong association was found between respiratory viral infection and pneumococcal acquisition.
Pneumococcal acquisition was significantly associated with acute respiratory infection with viral co-infections.
“In summary, this study assessed the role of influenza and other common respiratory viruses, including parainfluenza virus, respiratory syncytial virus, metapneumovirus, human rhinovirus, and adenovirus on pneumococcal acquisition,” the researchers wrote. “Exposure to an influenza or parainfluenza acute respiratory infection facilitates acquisition of new pneumococcal serotypes in young children, whereas exposure to other study respiratory viruses did not. This association seemed to be especially strong among children who were already colonized with pneumococcus. Our study findings suggest a selective synergism between certain respiratory viruses and the pneumococcus. Further research into the specific mechanisms of pneumococcal interaction with influenza and parainfluenza is warranted. As pneumococcal acquisition increases the risk pf pneumococcal diseases, these observations are pivotal to developing strategies for disease prevention.”