School of Medicine, Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Chía, Colombia; Bioscience PhD, Engineering School, Universidad de La Sabana, Chía, Colombia.
School of Medicine, Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Chía, Colombia; Unisabana Center for Translational Science, Universidad de La Sabana, Chía, Colombia.
Vaccine. 2024 Apr 19;42(11):2747-2757. doi: 10.1016/j.vaccine.2024.03.041. Epub 2024 Mar 20.
Streptococcus pneumoniae (Spn) is a commensal pathogen that usually colonizes the upper respiratory tract of children. Likewise, Spn colonization has been considered a critical factor in the development of pneumococcal invasive disease. However, Spn prevalence in adults remains unclear. This study performs a systematic review and meta-analysis to explore the prevalence of Spn Nasopharynx - Oropharynx Colonization (NOC) in adults.
A Systematic review of scientific databases was utilized to identify eligible studies that follow strict selection criteria. Subsequently, a meta-analysis was conducted to establish NOC prevalence in adults (≥18 years old). The heterogeneity and sensitivity analyses were assessed using the microorganism identification technique, sample type, and age subgroups.
Initial selection includes 69 studies, with 37 selected for the meta-analysis, involving 23,724 individuals. The overall prevalence (95 % CI) of Spn NOC among adults was 6 % (5-9). The subgroup analysis revealed that young adults (YA), 18-64 years old, had a prevalence of 10 %, whereas older adults (OA), ≥65 years old, had a prevalence of 2 %. The identification of Spn NOC may vary depending on the method of diagnosis used. High heterogeneity (I2 > 90 %) was observed but diminished to 70 % when the analysis was restricted to oropharyngeal swabs as an identification method. Furthermore, heterogeneity decreased to 58 % when exclusively employing traditional culture as the identification method.
This study found a low prevalence of Spn NOC in adults. Notably, the prevalence of Spn NOC was higher in younger adults than in older adults. It is essential to highlight a significant heterogeneity among studies, which indicates there is no standardized method of Spn NOC identification.
肺炎链球菌（Spn）是一种共生病原体，通常定植于儿童的上呼吸道。同样，Spn 定植被认为是导致肺炎球菌侵袭性疾病的关键因素。然而，成人中 Spn 的流行情况尚不清楚。本研究进行了系统评价和荟萃分析，以探讨成人中 Spn 鼻咽-口咽定植（NOC）的流行情况。
系统检索科学数据库，以确定符合严格选择标准的研究。随后，进行荟萃分析以确定成人（≥18 岁）中 NOC 的流行率。使用微生物鉴定技术、样本类型和年龄亚组评估异质性和敏感性分析。
最初筛选出 69 项研究，其中 37 项研究被纳入荟萃分析，共涉及 23724 人。成人中 Spn NOC 的总体流行率（95%CI）为 6%（5-9）。亚组分析显示，18-64 岁的年轻成年人的流行率为 10%，而≥65 岁的老年成年人的流行率为 2%。Spn NOC 的鉴定可能因所使用的诊断方法而异。观察到高度异质性（I2>90%），但当分析仅限于咽拭子作为鉴定方法时，异质性降至 70%。此外，当仅使用传统培养作为鉴定方法时，异质性降至 58%。
本研究发现成人中 Spn NOC 的流行率较低。值得注意的是，年轻成年人中 Spn NOC 的流行率高于老年成年人。需要强调的是，研究之间存在显著的异质性，这表明目前没有标准化的 Spn NOC 鉴定方法。
