El Safadi Dima, Hitchins Lisa, Howard Ashleigh, Aley Parvinder, Bowman Jaclyn, Bertran Marta, Collins Andrea, Colin-Jones Rachel, Elterish Filora, Fry Norman K, Gordon Stephen S, Gould Kate, Hinds Jason, Horn Emilie, Hyder-Wright Angela, Kandasamy Rama, Ladhani Shamez, Litt David, Mitsi Elena, Murphy Annabel, Pollard Andrew J, Plested Emma, Pojar Sherin, Ratcliffe Helen, Robertson Maria C, Robinson Hannah, Snape Matthew D, Solórzano Carla, Voysey Merryn, Begier Elizabeth, Catusse Julie, Lahuerta Maria, Theilacker Christian, Gessner Bradford D, Tiley Karen S, Ferreira Daniela M
Department of Clinical Sciences, Liverpool School of Tropical Medicine.
Oxford Vaccine Group, Department of Paediatrics, University of Oxford.
J Infect Dis. 2025 Feb 4;231(1):e17-e27. doi: 10.1093/infdis/jiae351.
Pneumococcal carriage in healthy adults and its relationship to invasive pneumococcal disease (IPD) is not well understood.
Nasal wash samples from adults without close contact with young children (Liverpool, UK), 2011-2019, were cultured, and culture-negative samples tested by polymerase chain reaction (PCR). Pneumococcal carriage in adults 18-44 years was compared with carriage among pneumococcal conjugate vaccine-vaccinated children aged 13-48 months (nasopharyngeal swabs, Thames Valley, UK) and national IPD data, 2014-2019. Age group-specific serotype invasiveness was calculated and used with national IPD data to estimate carriage serotype distributions for ≥65 years.
Overall, 98 isolates (97 carriers) were identified (3 solely by PCR) from 1631 ≥18 years adults (standardized carriage prevalence 6.4%). Despite different carriage and IPD serotype distributions between adults and children, serotype invasiveness was highly correlated (R = 0.9). Serotypes 3, 37, and 8 represented a higher proportion of adult carriage than expected. Predicted carriage serotype distributions for ≥65 years aligned closest with the young adult carriage serotype distribution.
Nasal wash technique is highly sensitive. For some serotypes carried by adults aged ≥65 years, other adults may be an important reservoir for transmission. Age groups such as older children should also be considered.
健康成年人中的肺炎球菌携带情况及其与侵袭性肺炎球菌病（IPD）的关系尚未完全明确。
对2011年至2019年期间来自英国利物浦、未与幼儿密切接触的成年人的洗鼻样本进行培养，对培养阴性的样本进行聚合酶链反应（PCR）检测。将18至44岁成年人的肺炎球菌携带情况与接种肺炎球菌结合疫苗的13至48个月儿童（英国泰晤士河谷地区的鼻咽拭子）的携带情况以及2014年至2019年的全国IPD数据进行比较。计算特定年龄组的血清型侵袭性，并结合全国IPD数据估计≥65岁人群的携带血清型分布。
总体而言，从1631名≥18岁成年人中鉴定出98株分离株（97名携带者）（3株仅通过PCR鉴定）（标准化携带率6.4%）。尽管成年人和儿童的携带及IPD血清型分布不同，但血清型侵袭性高度相关（R = 0.9）。血清型3、37和8在成人携带中所占比例高于预期。预测的≥65岁人群的携带血清型分布与年轻成年人的携带血清型分布最为接近。
洗鼻技术高度敏感。对于≥65岁成年人携带的某些血清型，其他成年人可能是重要的传播源。还应考虑大龄儿童等年龄组。
