HIV and influenza infection are associated with increased blood pneumococcal load : a prospective, hospital-based observational study in South Africa, 2009–2011

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dc.contributor.author Wolter, Nicole
dc.contributor.author Cohen, Cheryl
dc.contributor.author Tempia, Stefano
dc.contributor.author Madhi, Shabir A.
dc.contributor.author Venter, Marietjie
dc.contributor.author Moyes, Jocelyn
dc.contributor.author Walaza, Sibongile
dc.contributor.author Kgokong, Babatyi
dc.contributor.author Groome, Michelle
dc.contributor.author Du Plessis, Mignon
dc.contributor.author Pretorius, Marthi A.
dc.contributor.author Dawood, Halima
dc.contributor.author Kahn, Kathleen
dc.contributor.author Variava, Ebrahim
dc.contributor.author Klugman, Keith P.
dc.contributor.author Von Gottberg, Anne
dc.date.accessioned 2015-11-16T08:54:25Z
dc.date.available 2015-11-16T08:54:25Z
dc.date.issued 2014-01
dc.description.abstract BACKGROUND : Increased pneumococcal loads are associated with severe outcomes. We determined the prevalence of pneumococcal DNA in blood specimens from patients hospitalized with acute lower respiratory tract infection and identified factors associated with invasive pneumococcal pneumonia, bacterial loads, and death. METHODS : A total of 8523 patients were enrolled as part of prospective hospital-based surveillance. Blood was collected for quantitative pneumococcal (lytA) detection, and nasopharyngeal specimens were collected for detection of influenza virus and other respiratory viruses by real-time polymerase chain reaction. RESULTS : Of 6396 cases (75%) with lytA results, 422 (7%) were positive for pneumococcal DNA. The prevalences of human immunodeficiency virus (HIV) and influenza virus were 51% (2965/5855) and 8% (485/6358), respectively. On multivariable analysis, HIV infection (adjusted odds ratio [aOR], 2.4; 95% confidence interval [CI], 1.6–3.6), influenza virus coinfection (aOR, 1.4; 95% CI, 1.2–2.1), oxygen therapy during admission (aOR, 1.6; 95% CI, 1.1– 2.3) and in-hospital death (aOR, 2.1; 95% CI, 1.1–4.0) were significantly associated with increased pneumococcal load. Among lytA-positive patients, after adjustment for length of hospitalization, duration of symptoms, and oxygen therapy during admission, pneumococcal loads ≥10,000 DNA copies/mL (aOR, 3.6; 95% CI, 1.8–7.2) were associated with increased risk of death. CONCLUSIONS : HIV and influenza virus infections were associated with elevated pneumococcal loads, which, in turn, were associated with increased risk of death. en_ZA
dc.description.librarian hb2015 en_ZA
dc.description.uri http://jid.oxfordjournals.org en_ZA
dc.identifier.citation Wolter, N, Cohen, C, Tempia, S, Madhi, SA, Venter, M, Moyes, J, Walaza, S, Kgokong, B, Groome, M, Du Plessis, M, Pretorius, M, Dawood, H, Kahn, K, Variava, E, Klugman, KP & Von Gottberg, A 2014, 'HIV and influenza infection are associated with increased blood pneumococcal load : South Africa, 2009-2011', Journal of Infectious Diseases, vol. 209, no. 1, pp. 56-65. en_ZA
dc.identifier.issn 0022-1899 (print)
dc.identifier.issn 1537-6613 (online)
dc.identifier.other 10.1093/infdis/jit427
dc.identifier.uri http://hdl.handle.net/2263/50487
dc.language.iso en en_ZA
dc.publisher Oxford University Press en_ZA
dc.rights © The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Infectious Diseases following peer review. The definitive publisher-authenticated version is : HIV and influenza infection are associated with increased blood pneumococcal load : South Africa, 2009-2011, Journal of Infectious Diseases, vol. 209, no. 1, pp. 56-65, 2014. doi : 10.1093/infdis/jit427, is available online at : http://jid.oxfordjournals.org. en_ZA
dc.subject Streptococcus pneumoniae en_ZA
dc.subject Pneumococcal pneumonia en_ZA
dc.subject Bacterial load en_ZA
dc.subject Influenza en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Risk of death en_ZA
dc.title HIV and influenza infection are associated with increased blood pneumococcal load : a prospective, hospital-based observational study in South Africa, 2009–2011 en_ZA
dc.type Postprint Article en_ZA


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