Grant Lindsay R, Sutcliffe Catherine G, Littlepage Shea, Alexander-Parrish Ronika, Becenti Ladonna, Isturiz Raul E, Jacobs Michael R, O'Brien Katherine L, Riley Dennie Parker, Santosham Mathuram, Tso Carol, Vidal Jorge E, Weatherholtz Robert C, Hammitt Laura L
Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Vaccines, Medical Development and Scientific Clinical Affairs, Pfizer, Inc, Collegeville, Pennsylvania.
J Infect Dis. 2025 Jul 11;231(6):e1045-e1056. doi: 10.1093/infdis/jiaf091.
In the United States, the invasive pneumococcal disease incidence in Indigenous populations is higher than in the general population. Molecular detection and/or specimen sampling from multiple body sites could enhance our understanding of pneumococcal carriage, a prerequisite for disease.
Persons aged <5 and ≥18 years from the Navajo Nation and White Mountain Apache Tribal lands were enrolled in an observational carriage study from October 2015 through September 2017. Swabs from the nasopharynx (all participants) and oropharynx (adults only) were collected and tested by enriched culture or molecular methods (lytA and piaB polymerase chain reaction [PCR]). Cultured Streptococcus pneumoniae was serotyped by sequencing. PCR-positive samples were serotyped by 13-valent pneumococcal conjugate vaccine (PCV13)-type PCR and TaqMan array card PCR.
An overall 1503 participants were enrolled (age <5 years, n = 600; ≥18 years, n = 903). Among children, pneumococcal positivity was similar by culture (49.5%) and PCR (50.8%); PCV13-type carriage was 8.0% by any method. Among adults, oropharyngeal swab positivity by PCR was 18.5%, an increase when compared with cultured oropharyngeal swabs (0.6%) and nasopharyngeal swabs by culture (7.9%) or PCR (5.3%); PCV13-type carriage by any sample or method was 8.0%.
PCV13-type carriage persists in Indigenous populations. Use of molecular methods and oropharyngeal swabs for adults increased carriage prevalence estimates.
在美国，原住民人群侵袭性肺炎球菌疾病的发病率高于普通人群。对多个身体部位进行分子检测和/或样本采集，有助于我们更好地了解肺炎球菌携带情况，而这是疾病发生的一个先决条件。
2015年10月至2017年9月，纳瓦霍族和白山阿帕奇部落土地上年龄小于5岁和大于等于18岁的人群参与了一项观察性携带情况研究。采集鼻咽部（所有参与者）和口咽部（仅成人）的拭子，通过富集培养或分子方法（lytA和piaB聚合酶链反应[PCR]）进行检测。对培养出的肺炎链球菌进行测序血清分型。PCR阳性样本通过13价肺炎球菌结合疫苗（PCV13）型PCR和TaqMan阵列卡PCR进行血清分型。
共纳入1503名参与者（年龄小于5岁，n = 600；大于等于18岁，n = 903）。在儿童中，培养法（49.5%）和PCR法（50.8%）检测到的肺炎球菌阳性率相似；通过任何方法检测到的PCV13型携带率为8.0%。在成人中，PCR检测的口咽拭子阳性率为18.5%，与培养的口咽拭子（0.6%）以及培养或PCR检测的鼻咽拭子（分别为7.9%和5.3%）相比有所增加；通过任何样本或方法检测到的PCV13型携带率为8.0%。
PCV13型携带情况在原住民人群中持续存在。对成人使用分子方法和口咽拭子可提高携带率的估计值。
