Infant Pneumococcal Carriage During Influenza, RSV, and hMPV Respiratory Illness Within a Maternal Influenza Immunization Trial

Alastair F Murray, Janet A Englund, Jane Kuypers, James M Tielsch, Joanne Katz, Subarna K Khatry, Steven C Leclerq, Helen Y Chu, Alastair F Murray, Janet A Englund, Jane Kuypers, James M Tielsch, Joanne Katz, Subarna K Khatry, Steven C Leclerq, Helen Y Chu

Abstract

In this post-hoc analysis of midnasal pneumococcal carriage in a community-based, randomized prenatal influenza vaccination trial in Nepal with weekly infant respiratory illness surveillance, 457 of 605 (75.5%) infants with influenza, respiratory syncytial virus (RSV), or human metapneumovirus (hMPV) illness had pneumococcus detected. Pneumococcal carriage did not impact rates of lower respiratory tract disease for these 3 viruses. Influenza-positive infants born to mothers given influenza vaccine had lower pneumococcal carriage rates compared to influenza-positive infants born to mothers receiving placebo (58.1% versus 71.6%, P = 0.03). Maternal influenza immunization may impact infant acquisition of pneumococcus during influenza infection. Clinical Trials Registration. NCT01034254.

Keywords: RSV; hMPV; influenza; maternal immunization; pneumococcus; vaccine.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Nasopharyngeal pneumococcal carriage status in infants with respiratory illness in the context of a maternal influenza vaccine trial in Nepal, 2011–2014. Significantly lower rates of pneumococcal carriage were seen in influenza-positive infants of mothers who received the flu vaccine (P = .03, age-adjusted multivariable logistic regression). RSV-positive and hMPV-positive infants served as age-adjusted negative control groups. Abbreviations: hMPV, human metapneumovirus; RSV, respiratory syncytial virus; S. pneumoniae, Streptococcus pneumoniae.

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Source: PubMed

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