Print E-mail
Volume 42, Number 3, June 2009

Streptococcus pneumoniae colonization among patients with human immunodeficiency virus–1 who had received 23-valent polysaccharide pneumococcal vaccine


Yi-Chun Lo, Tsai-Ling Lauderdale, Sui-Yuan Chang, Chin-Fu Hsiao, Chien-Ching Hung, Shan-Chwen Chang
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei; Division of Clinical Research, National Health Research Institutes, Chu-Nan; Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei; and Division of Biostatistics and Bioinformatics, National Health Research Institutes, Chu-Nan, Taiwan

Received: February 29, 2008    Revised: May 20, 2008    Accepted: June 26, 2008   

 

Corresponding author:

Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan. E-mail: Chien-Ching Hung This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 



 

Background and purpose: 

To evaluate the impact of 23-valent polysaccharide pneumococcal vaccine on Streptococcus pneumoniae colonization in the upper airway of patients with human immunodeficiency virus (HIV)–1 in Taiwan.
 



 

Methods:

302 HIV-infected patients aged 15 years or older underwent swab cultures of the posterior pharynx and tonsils for S. pneumoniae between June 1, 2000 and June 30, 2002. 198 patients (65.6%) had received 23-valent polysaccharide pneumococcal vaccine with a median interval of 420 days (range, 27-634 days) before cultures were performed. Clinical characteristics and laboratory findings were analyzed to determine the factors associated with S. pneumoniae colonization in the upper airway.
 



 

Results:

Twenty patients (6.6%) had colonization with S. pneumoniae: 15 of 198 patients (7.6%) who had received 23-valent polysaccharide pneumococcal vaccine and 5 of 104 patients (4.8%) who had not received the vaccine (p = 0.37). According to the multivariate analysis, smoking was the only factor that was statistically significantly associated with S. pneumoniae colonization (adjusted odds ratio, 4.03; 95% confidence interval, 1.04-15.64; p = 0.04); pneumococcal vaccination was not statistically significantly associated with S. pneumoniae colonization.
 



 

Conclusion:

Among HIV-infected patients, smoking was the only factor significantly associated with a higher prevalence of upper airway colonization by S. pneumoniae. As previous receipt of 23-valent polysaccharide pneumococcal vaccine was not associated with a lower prevalence of S. pneumoniae colonization, a better vaccination strategy, in addition to smoking cessation, may be needed to reduce S. pneumoniae colonization in HIV-infected adults.



 

Key words:

Acquired immunodeficiency syndrome; Antiretroviral therapy, highly active; HIV infections; HIV-1; Pneumococcal vaccines; Streptococcus pneumoniae

 



 

J Microbiol Immunol Infect. 2009;42:234-242.