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

dc.contributor.authorWolter, Nicole
dc.contributor.authorCohen, Cheryl
dc.contributor.authorTempia, Stefano
dc.contributor.authorMadhi, Shabir A.
dc.contributor.authorVenter, Marietjie
dc.contributor.authorMoyes, Jocelyn
dc.contributor.authorWalaza, Sibongile
dc.contributor.authorKgokong, Babatyi
dc.contributor.authorGroome, Michelle
dc.contributor.authorDu Plessis, Mignon
dc.contributor.authorPretorius, Marthi Andréa
dc.contributor.authorDawood, Halima
dc.contributor.authorKahn, Kathleen
dc.contributor.authorVariava, Ebrahim
dc.contributor.authorKlugman, Keith P.
dc.contributor.authorVon Gottberg, Anne
dc.date.accessioned2015-11-16T08:54:25Z
dc.date.available2015-11-16T08:54:25Z
dc.date.issued2014-01
dc.description.abstractBACKGROUND : 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.librarianhb2015en_ZA
dc.description.urihttp://jid.oxfordjournals.orgen_ZA
dc.identifier.citationWolter, 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.issn0022-1899 (print)
dc.identifier.issn1537-6613 (online)
dc.identifier.other10.1093/infdis/jit427
dc.identifier.urihttp://hdl.handle.net/2263/50487
dc.language.isoenen_ZA
dc.publisherOxford University Pressen_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.subjectStreptococcus pneumoniaeen_ZA
dc.subjectPneumococcal pneumoniaen_ZA
dc.subjectBacterial loaden_ZA
dc.subjectInfluenzaen_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectRisk of deathen_ZA
dc.titleHIV and influenza infection are associated with increased blood pneumococcal load : a prospective, hospital-based observational study in South Africa, 2009–2011en_ZA
dc.typePostprint Articleen_ZA

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