Nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in a Brazilian elderly cohort

We aimed to investigate the nasopharyngeal colonization (NPC) by Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in the elderly population and to assess the demographic factors associated with NPC. This was an observational cohort study in which outpatients aged ≥60 years...

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Bibliographic Details
Published in:PloS one 2019-08, Vol.14 (8), p.e0221525-e0221525
Main Authors: Zanella, Rosemeire Cobo, Brandileone, Maria Cristina de Cunto, Almeida, Samanta Cristine Grassi, de Lemos, Ana Paula Silva, Sacchi, Claudio Tavares, Gonçalves, Claudia R, Gonçalves, Maria Gisele, Fukasawa, Lucila Okuyama, Saraiva, Marcos Daniel, Rangel, Luís Fernando, Cunha, Julia Lusis Lassance, Rotta, Thereza Cristina Ariza, Douradinho, Christian, Jacob-Filho, Wilson, Minamisava, Ruth, Andrade, Ana Lúcia
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Ambulatory care facilities
Antibiotics
Bacteria
Bacteriology
Biology and Life Sciences
Brazil
Carrier State - microbiology
Chronic kidney failure
Chronic obstructive lung disease
Chronic obstructive pulmonary disease
Cohort Studies
Colonization
Data collection
Demographics
Diabetes mellitus
Drug resistance
Elderly
Epidemiology
Female
Follow-Up Studies
Geriatrics
Haemophilus influenzae
Haemophilus influenzae - physiology
Health aspects
Health risks
Hemophilus infections
Hospitals
Humans
Immunization
Immunology
Influenza
Influenza vaccines
Kidney diseases
Laboratories
Lung diseases
Male
Medical research
Medical schools
Medicine and Health Sciences
Meningitis
Methicillin
Microbiology
Middle Aged
Molecular biology
Nasopharynx - microbiology
Obstructive lung disease
Older people
Oxacillin
People and Places
Pneumonia
Polysaccharides
Population
Respiratory tract diseases
Risk analysis
Risk Factors
Serotypes
Staphylococcus aureus
Staphylococcus aureus - physiology
Staphylococcus infections
Streptococcus infections
Streptococcus pneumoniae
Streptococcus pneumoniae - physiology
Studies
Toxins
Urine
Vaccination
Vaccines
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Summary:We aimed to investigate the nasopharyngeal colonization (NPC) by Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in the elderly population and to assess the demographic factors associated with NPC. This was an observational cohort study in which outpatients aged ≥60 years were enrolled from April to August 2017, with a follow-up visit from September through December 2017. Nasopharyngeal (NP) swabs were collected, bacteria were detected and isolated, and isolates were subjected to phenotypic and molecular characterization using standard microbiological techniques. At enrolment, the rates of S. aureus, methicillin-resistant S. aureus (MRSA), H. influenzae, and S. pneumoniae among 776 elderly outpatients were 15.9%, 2.3%, 2.5%, and 2.2%, respectively. Toxin production was detected in 21.1% of methicillin-susceptible S. aureus, and three SCCmec types were identified: II/IIb, IVa, and VI. At the follow-up visit, all carriage rates were similar (p > 0.05) to the rates at enrolment. Most of S. pneumoniae serotypes were not included in pneumococcal conjugate vaccines (PCVs), except for 7F, 3, and 19A. All strains of H. influenzae were non-typeable. Previous use of antibiotics and 23-valent pneumococcal polysaccharide vaccination (p < 0.05) were risk factors for S. aureus and MRSA carriage; S. aureus colonization was also associated with chronic kidney disease (p = 0.021). S. pneumoniae carriage was associated with male gender (p = 0.032) and an absence of diabetes (p = 0.034), while not receiving an influenza vaccine (p = 0.049) and chronic obstructive pulmonary disease (p = 0.031) were risk factors for H. influenzae colonization. The frailty of study participants was not associated with colonization status. We found a higher S. aureus carriage rate compared with the S. pneumoniae- and H. influenzae-carriage rates in a well-attended population in a geriatric outpatient clinic. This is one of the few studies conducted in Brazil that can support future colonization studies among elderly individuals.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0221525