You are here: Home Published Research Streptococcus pneumoniae and non-typable Haemophilus influenzae causing bacterial bronchitis in children and the impact of vaccination.

Kostas N Priftis, David Litt, Sapna Manglani, Michael B Anthracopoulos, Keith Thickett, Georgina Tzanakaki, Patricia Fenton, George A Syrogiannopoulos, Aliki Vogiatzi, Konstantinos Douros, Mary Slack, and Mark L Everard (2012)

Streptococcus pneumoniae and non-typable Haemophilus influenzae causing bacterial bronchitis in children and the impact of vaccination.


ABSTRACT BACKGROUND: Protracted bacterial bronchitis is a major cause of persistent cough in childhood. The organisms most commonly isolated are non-typable Haemophilus influenzae [NTHi] and Streptococcus pneumoniae [SP]. There are no studies addressing typing of these organisms when recovered from the lower airways. METHODS: Isolates of these two organisms identified in bronchoalveolar lavage (BAL) samples from children undergoing routine investigation of a chronic cough thought to be attributable to a protracted bacterial bronchitis were subject to typing. Samples were collected in Sheffield, UK and Athens, Greece. The majority of the children from Sheffield had received PCV-7 or PCV-13 conjugate vaccine but only a minority of Greek children had received the PCV-7 vaccine. RESULTS: All 18 SP isolates from Greek BAL samples are serotypes contained in PCV-13 while 10 are contained in PCV-7. In contrast, 28 of the 39 samples from Sheffield contained serotypes that are not included in PCV-13. All 26 of the NTHi samples obtained in Sheffield produced distinct MLVA profiles. There was a significant difference between children from Athens and Sheffield in the distribution of serotypes contained or not in the pneumococcal vaccine (p=0.04). More specifically, immunisation with pneumococcal vaccine was related with isolation of S. pneumoniae serotypes not included in the vaccine [OR: 0.021, CI: 0.003-0.115, p<0.001]. CONCLUSIONS: The data suggests that both vaccine and non-vaccine Strep. pneumoniae serotypes may play a role in protracted bacterial bronchitis and provide some hints that serotype replacement may occur in response to the introduction of conjugate vaccines.Dept. Of Respiratory Medicine, Sheffield Children's Hospital, Sheffield, S10 2TH UK*Third Dept. of Paediatrics, ``Attikon'' Hospital, University of Athens School of Medicine, Athens, Greece 1 Rimini Str, Chaidari 12464, Greece# Respiratory & Systemic Infection Laboratory, Health Protection Agency, Microbiology Services Division Colindale, 61 Colindale Avenue, London NW9 5HT, UK$Respiratory Unit, Dept of Paediatrics, University of Patras, Patra, Greece^Microbiology Dept. Royal Hallamshire Hospital, Sheffield, S10 2JFUK∼Microbiology Dept, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH@National Meningitis Reference Laboratory, National School of Public Health, Athens, Greece,+Dept. of Pediatrics, University of Thessaly, School of Medicine, General University Hospital of Larissa, Greece%Dept. of Clinical Microbiology, Penteli Children's Hospital, Athens, Greece,Corresponding author: Prof. Mark Everard, Dept. of Respiratory Medicine, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH UK, Email:

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