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. 2020 Aug;81(2):213-220.
doi: 10.1016/j.jinf.2020.06.013. Epub 2020 Jun 10.

Viral-bacterial (co-)occurrence in the upper airways and the risk of childhood pneumonia in resource-limited settings

James S Ngocho  1 , Linda Minja  2 , Christa E van der Gaast-de Jongh  3 , Janette C Rahamat-Langendoen  4 , Jeroen D Langereis  3 , Blandina T Mmbaga  5 , Marien I de Jonge  3
Affiliations

Viral-bacterial (co-)occurrence in the upper airways and the risk of childhood pneumonia in resource-limited settings

James S Ngocho et al. J Infect. 2020 Aug.

Abstract

Objective: To examine the association between bacterial-viral co-occurrence in the nasopharynx and the risk of community acquired pneumonia (CAP) in young children living in resource-limited settings.

Methods: A case-control study was conducted between January and December 2017 in Moshi, Tanzania. Children 2-59 months with CAP and healthy controls were enrolled. RSV and Influenza A/B were detected with a standardized polymerase chain reaction (PCR) method, and a simplified real-time quantitative PCR method, without sample pre-processing, was developed to detect bacterial pathogens in nasopharyngeal samples.

Results: A total of 109 CAP patients and 324 healthy controls were enrolled. Co-detection of H. influenzae and S. pneumoniae in nasopharyngeal swabs was linked with higher odds of CAP (aOR=3.2, 95% CI=1.1-9.5). The majority of the H. influenzae isolated in cases and controls (95.8%) were non-typeable. Of the viruses examined, respiratory syncytial virus (RSV) was most common (n = 31, 7.2%) in cases and controls. Children with RSV had 8.4 times higher odds to develop pneumonia than healthy children (aOR=8.4, 95%CI= 3.2 - 22.1).

Conclusions: Co-occurence of H. influenzae and S. pneumoniae in the nasopharynx was strongly associated with CAP. The high prevalence of non-typeable H. influenzae might be a sign of replacement as a consequence of Haemophilus influenzae type b vaccination.

Keywords: Bacterial and viral colonization; Children under five years of age; Community-acquired pneumonia; Tanzania.

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Conflict of interest statement

Declaration of Competing Interest None.

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