Pneumococcal coinfection with human metapneumovirus.

Abstract

BACKGROUND:

Infection with the newly discovered human metapneumovirus (hMPV) may lead to hospitalization of children with lower respiratory tract infection (LRTI), although the pathogenesis thereof remains to be elucidated.

METHODS:

This hypothesis-generating study involved a cohort of children randomized to receive 9-valent conjugate pneumococcal vaccine or placebo and who were tested for hMPV infection when hospitalized for LRTI. By use of a nested reverse-transcription polymerase chain reaction assay targeted at amplifying a fragment of the hMPV fusion (F) protein gene, 202 such infections were identified among 2715 episodes of LRTI in children.

RESULTS:

Among human immunodeficiency virus (HIV)-uninfected children who had received 3 doses of conjugate pneumococcal vaccine, the incidence of hMPV-associated LRTI was reduced by 45% (95% confidence interval [CI], 19%-62%; P = .002), and the incidence of clinical pneumonia was reduced by 55% (95% CI, 22%-74%; P = .003). Similarly, in fully vaccinated HIV-infected children, the incidence of hMPV-associated LRTI was reduced by 53% (95% CI, 3%-77%; P = .035), and that of clinical pneumonia was reduced by 65% (95% CI, 19%-85%; P = .020).

CONCLUSIONS:

The pathogenesis of hMPV-associated LRTI that results in hospitalization of both HIV-infected and -uninfected children involves bacterial coinfection with pneumococcus, and a significant proportion of these hospitalizations may be prevented by vaccination with pneumococcal conjugate vaccine.

• Authors: Shabir A Madhi, Herbert Ludewick, Locadiah Kuwanda, Nadia van Niekerk, Clare Cutland, Tessa Little, Keith P Klugman
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 193 Issue 9 Pg. 1236-43 (May 01 2006) ISSN: 0022-1899 [Print] United States
• PMID: 16586360 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Pneumococcal Vaccines
• Vaccines, Conjugate

Topics

• Child
• Child, Preschool
• Female
• Humans
• Male
• Metapneumovirus (isolation & purification)
• Paramyxoviridae Infections (complications, diagnosis, epidemiology)
• Pneumococcal Infections (complications, prevention & control)
• Pneumococcal Vaccines (therapeutic use)
• Pneumonia, Viral (complications, diagnosis, epidemiology)
• Streptococcus pneumoniae
• Vaccines, Conjugate (therapeutic use)