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Pneumococcal colonisation is an asymptomatic event in healthy adults using an experimental human colonisation model

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Trimble, Ashleigh, Connor, Victoria, Robinson, Ryan, McLenaghan, Daniella, Hancock, Carole, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464, Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116, Ferreira, Daniela ORCID: https://orcid.org/0000-0002-0594-0902, Hyder-Wright, Angela and Collins, Andrea ORCID: https://orcid.org/0000-0002-4094-1572 (2020) 'Pneumococcal colonisation is an asymptomatic event in healthy adults using an experimental human colonisation model'. PLoS ONE, Vol 15, Issue 3, E0229558.

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Abstract

Introduction
Pneumococcal colonisation is regarded as a pre-requisite for developing pneumococcal disease. In children previous studies have reported pneumococcal colonisation to be a symptomatic event and described a relationship between symptom severity/frequency and colonisation density. The evidence for this in adults is lacking in the literature. This study uses the experimental human pneumococcal challenge (EHPC) model to explore whether pneumococcal colonisation is a symptomatic event in healthy adults.

Methods
Healthy participants aged 18–50 were recruited and inoculated intra-nasally with either Streptococcus pneumoniae (serotypes 6B, 23F) or saline as a control. Respiratory viral swabs were obtained prior to inoculation. Nasal and non-nasal symptoms were then assessed using a modified Likert score between 1 (no symptoms) to 7 (cannot function). The rate of symptoms reported between the two groups was compared and a correlation analysis performed.

Results
Data from 54 participants were analysed. 46 were inoculated with S. pneumoniae (29 with serotype 6B, 17 with serotype 23F) and 8 received saline (control). In total, 14 became experimentally colonised (30.4%), all of which were inoculated with serotype 6B. There was no statistically significant difference in nasal (p = 0.45) or non-nasal symptoms (p = 0.28) between the inoculation group and the control group. In those who were colonised there was no direct correlation between colonisation density and symptom severity. In the 22% (12/52) who were co-colonised, with pneumococcus and respiratory viruses, there was no statistical difference in either nasal or non-nasal symptoms (virus positive p = 0.74 and virus negative p = 1.0).

Conclusion
Pneumococcal colonisation using the EHPC model is asymptomatic in healthy adults, regardless of pneumococcal density or viral co-colonisation.

Item Type: Article
Subjects: QV Pharmacology > Drug Standardization. Pharmacognosy. Medicinal Plants > QV 771 Standardization and evaluation of drugs
QW Microbiology and Immunology > Bacteria > QW 142 Gram-positive bacteria (General)
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pone.0229558
Depositing User: Catherine Molloy
Date Deposited: 12 Mar 2020 15:00
Last Modified: 13 Mar 2020 16:43
URI: https://archive.lstmed.ac.uk/id/eprint/13790

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