ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Density of Upper Respiratory Colonization With Streptococcus pneumoniae and Its Role in the Diagnosis of Pneumococcal Pneumonia Among Children Aged <5 Years in the PERCH Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers.
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Who cites it
66 citing papers in PubMed, 108 citations in OpenAlex.
- The effect of live attenuated influenza vaccine on pneumococcal colonisation densities among children aged 24-59 months in The Gambia: a phase 4, open label, randomised, controlled trial.The Lancet. Microbe · 2021Trial
- Nasopharyngeal Microbiota in South African Infants With Lower Respiratory Tract Infection: A Nested Case-Control Study of the Drakenstein Child Health Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Evaluating the effectiveness of the 13-valent pneumococcal conjugate vaccine and clinical and demographic characteristics on pneumococcal carriage density in young children in Papua New Guinea, Lao PDR, and Mongolia.BMC infectious diseases · 2025Article
- Role of the upper airway microbiota in respiratory virus and bacterial pathobiont dynamics in the first year of life.Nature communications · 2025Article
- Pneumococcal density and respiratory co-detection in severe pediatric pneumonia in Laos.Scientific reports · 2025Article
- Nasopharyngeal carriage of Streptococcus pneumoniae among Brazilian children: Interplay with viral co-infection.PloS one · 2025Article
- Rapid diagnostic value of next-generation sequencing-based technologies in childhood pneumonia.Frontiers in pediatrics · 2025Article
- Streptococcus pneumoniae serotype distribution in Bangladeshi under-fives with community-acquired pneumonia pre-10-valent pneumococcal conjugate vaccination.Pneumonia (Nathan Qld.) · 2024Article
- Pneumococcal colonization and coinfecting respiratory viruses in children under 5 years in Addis Ababa, Ethiopia: a prospective case-control study.Scientific reports · 2024Article
- Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment.Clinical and experimental pediatrics · 2024Article
- Co-occurrence of bacteria and viruses and serotype distribution ofFrontiers in public health · 2024Article
- Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study.PloS one · 2024Article
- Circulating markers of neutrophil activation and lung injury in pediatric pneumonia in low-resource settings.Pathogens and global health · 2023Article
- Article
- Streptococcus pneumoniae and other bacterial nasopharyngeal colonization seven years post-introduction of 13-valent pneumococcal conjugate vaccine in South African children.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Association between nasopharyngeal colonization with multiple pneumococcal serotypes and total pneumococcal colonization density in young Peruvian children.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Effectiveness of Pneumococcal Conjugate Vaccination Against Virus-Associated Lower Respiratory Tract Infection Among Adults: A Case-Control Study.The Journal of infectious diseases · 2023Article
- Nasopharyngeal Carriage of Streptococcus pneumoniae Serotypes Among Healthy Children in Northern India.Current microbiology · 2022Article
- Pneumococcal concentration and serotype distribution in preschool children with radiologically confirmed pneumonia compared to healthy controls prior to introduction of pneumococcal vaccination in Zanzibar: an observational study.BMC infectious diseases · 2022Observational
- Mechanistic Insights into the Impact of Air Pollution on Pneumococcal Pathogenesis and Transmission.American journal of respiratory and critical care medicine · 2022Review
6 more citing papers are in PubMed but not listed here.
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Authors and funding
36 authors at 18 institutions in 10 countries.
Funding
Abstract
BACKGROUND.: Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association. METHODS.: PERCH is a case-control study in 7 countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. Cases were children aged 1-59 months hospitalized with World Health Organization-defined severe or very severe pneumonia. Controls were randomly selected from the community. Microbiologically confirmed pneumococcal pneumonia (MCPP) was confirmed by detection of pneumococcus in a relevant normally sterile body fluid. Colonization density was calculated with quantitative polymerase chain reaction analysis of nasopharyngeal/oropharyngeal specimens. RESULTS.: Median colonization density among 56 cases with MCPP (MCPP cases; 17.28 × 106 copies/mL) exceeded that of cases without MCPP (non-MCPP cases; 0.75 × 106) and controls (0.60 × 106) (each P < .001). The optimal density for discriminating MCPP cases from controls using the Youden index was >6.9 log10 copies/mL; overall, the sensitivity was 64% and the specificity 92%, with variable performance by site. The threshold was lower (≥4.4 log10 copies/mL) when MCPP cases were distinguished from controls who received antibiotics before specimen collection. Among the 4035 non-MCPP cases, 500 (12%) had pneumococcal colonization density >6.9 log10 copies/mL; above this cutoff was associated with alveolar consolidation at chest radiography, very severe pneumonia, oxygen saturation <92%, C-reactive protein ≥40 mg/L, and lack of antibiotic pretreatment (all P< .001). CONCLUSIONS.: Pneumococcal colonization density >6.9 log10 copies/mL was strongly associated with MCPP and could be used to improve estimates of pneumococcal pneumonia prevalence in childhood pneumonia studies. Our findings do not support its use for individual diagnosis in a clinical setting.
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