Wyllie Anne L, Yolda-Carr Devyn, Hislop Maikel S, Mbodj Sidiya, Wurst Loren, Waghela Pari, Alexander-Parrish Ronika, Grant Lindsay R, Arguedas Adriano, Gessner Bradford D, Weinberger Daniel M
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, United States.
Pfizer Inc, Collegeville, PA 19426, United States.
FEMS Microbes. 2024 Oct 14;5:xtae032. doi: 10.1093/femsmc/xtae032. eCollection 2024.
Important questions remain about the sources of transmission of pneumococcus to older adults in the community. This is critical for understanding the potential effects of using pneumococcal conjugate vaccines (PCVs) in children and older adults. For non-institutionalized individuals, we hypothesized that the most likely source of adult-to-adult transmission is within the household. We designed a longitudinal study to sample adults ≥60 years of age living in the same household (New Haven, CT, USA), without younger residents in the household. Saliva samples and social and health questionnaires were obtained every 2 weeks for a period of 10 weeks. DNA extracted from culture-enriched saliva was tested using qPCR for pneumococcus genes , and serotype. Across two study seasons (November 2020-August 2021, November 2021-September 2022), 121 individuals from 61 households completed all six visits; 62 individuals were enrolled in both seasons. Overall, 52/1088 (4.8%) samples tested positive for pneumococcus, with 27/121 (22.3%) individuals colonized at least once. Several individuals were colonized at multiple time points; two individuals were colonized at 5/6 time points and two at all six. In 5 instances, both household members were carriers in the same season, though not necessarily at the same time. Pneumococcal carriage was substantially higher among individuals who had contact with children (10.0% vs. 1.6%). Contact with young children was the most important factor that influenced pneumococcal acquisition rates. While there were several instances where both adult household members were colonized at the same time or at sequential visits, these individuals typically had contact with children. As such, PCV immunization can directly protect older adults who have contact with children.
关于社区中肺炎球菌传播给老年人的来源，仍存在重要问题。这对于理解在儿童和老年人中使用肺炎球菌结合疫苗（PCV）的潜在影响至关重要。对于非机构化个体，我们假设成人之间传播的最可能来源是在家庭内部。我们设计了一项纵向研究，对居住在美国康涅狄格州纽黑文同一家庭中年龄≥60岁且家中没有年轻居民的成年人进行抽样。每2周采集一次唾液样本以及社会和健康问卷，为期10周。使用qPCR检测从富集培养的唾液中提取的DNA，以检测肺炎球菌基因和血清型。在两个研究季节（2020年11月至2021年8月，2021年11月至2022年9月），来自61个家庭的121名个体完成了全部六次访视；62名个体参与了两个季节的研究。总体而言，1088份样本中有52份（4.8%）肺炎球菌检测呈阳性，121名个体中有27名（22.3%）至少有一次被定植。有几个人在多个时间点被定植；两人在6个时间点中的5个被定植，两人在所有6个时间点都被定植。在5个实例中，同一季节的两名家庭成员均为携带者，尽管不一定是同时。与儿童有接触的个体中肺炎球菌携带率显著更高（10.0%对1.6%）。与幼儿接触是影响肺炎球菌感染率的最重要因素。虽然有几个实例显示成年家庭成员在同一时间或相继访视时均被定植，但这些个体通常与儿童有接触。因此，PCV免疫可直接保护与儿童有接触的老年人。
