TY - JOUR
T1 - Reduced nontypeable Haemophilus influenzae lower airway infection in children with chronic endobronchial suppuration vaccinated with the 10-valent pneumococcal H. influenzae protein D conjugate vaccine
AU - Hare, Kim M.
AU - Smith-Vaughan, Heidi C.
AU - Leach, Amanda J.
AU - Pizzutto, Susan J.
AU - McCallum, Gabrielle B.
AU - Chang, Anne B.
PY - 2018/3/20
Y1 - 2018/3/20
N2 - Background: Nontypeable Haemophilus influenzae (NTHi), the most common bacterial lower airway infection in children with protracted bacterial bronchitis, is associated with progression to bronchiectasis. We determined whether vaccination with 10-valent pneumococcal NTHi protein-D conjugate vaccine (PHiD-CV) reduced NTHi lower airway infection compared to children not PHiD-CV-vaccinated. Our unique childhood vaccination schedule and prospective 9-year bronchoalveolar lavage (BAL) collection provided an exclusive opportunity to examine this hypothesis. Methods: Paired BAL fluids and nasopharyngeal (NP) swabs were collected from 543 children (2007–2016) undergoing bronchoscopy for chronic cough. Children who received a primary course of ≥2 doses of one pneumococcal conjugate vaccine (PCV) and <2 doses of another PCV were included in each vaccine group. Logistic regression determined associations between NTHi lower airway infection (≥104 colony-forming units/mL BAL) and age, sex, Indigenous status, antibiotic exposure, and PHiD-CV vaccination. Results: Of 262 PCV7-vaccinated, 53 PHiD-CV-vaccinated and 166 PCV13-vaccinated children (62 had mixed schedules, <2 PCV doses or missing vaccination data), NTHi lower airway infection was detected in 89 (34%), 9 (17%) and 47 (28%), respectively. On multivariate regression, significant independent factors associated with reduced NTHi lower airway infection were PHiD-CV vaccination (ORadjusted = 0.42, 95%CI 0.19–0.93), macrolide use (ORadjusted = 0.57, 95%CI 0.35–0.93) and increasing age (ORadjusted = 0.88, 95%CI 0.80–0.96). PHiD-CV vaccination had no impact on NTHi NP carriage. Conclusions: PHiD-CV-vaccinated children were significantly less likely to have NTHi lower airway infection than children not PHiD-CV-vaccinated. PHiD-CV is likely an effective intervention for reducing NTHi endobronchial infection in children at risk of chronic suppurative lung diseases.
AB - Background: Nontypeable Haemophilus influenzae (NTHi), the most common bacterial lower airway infection in children with protracted bacterial bronchitis, is associated with progression to bronchiectasis. We determined whether vaccination with 10-valent pneumococcal NTHi protein-D conjugate vaccine (PHiD-CV) reduced NTHi lower airway infection compared to children not PHiD-CV-vaccinated. Our unique childhood vaccination schedule and prospective 9-year bronchoalveolar lavage (BAL) collection provided an exclusive opportunity to examine this hypothesis. Methods: Paired BAL fluids and nasopharyngeal (NP) swabs were collected from 543 children (2007–2016) undergoing bronchoscopy for chronic cough. Children who received a primary course of ≥2 doses of one pneumococcal conjugate vaccine (PCV) and <2 doses of another PCV were included in each vaccine group. Logistic regression determined associations between NTHi lower airway infection (≥104 colony-forming units/mL BAL) and age, sex, Indigenous status, antibiotic exposure, and PHiD-CV vaccination. Results: Of 262 PCV7-vaccinated, 53 PHiD-CV-vaccinated and 166 PCV13-vaccinated children (62 had mixed schedules, <2 PCV doses or missing vaccination data), NTHi lower airway infection was detected in 89 (34%), 9 (17%) and 47 (28%), respectively. On multivariate regression, significant independent factors associated with reduced NTHi lower airway infection were PHiD-CV vaccination (ORadjusted = 0.42, 95%CI 0.19–0.93), macrolide use (ORadjusted = 0.57, 95%CI 0.35–0.93) and increasing age (ORadjusted = 0.88, 95%CI 0.80–0.96). PHiD-CV vaccination had no impact on NTHi NP carriage. Conclusions: PHiD-CV-vaccinated children were significantly less likely to have NTHi lower airway infection than children not PHiD-CV-vaccinated. PHiD-CV is likely an effective intervention for reducing NTHi endobronchial infection in children at risk of chronic suppurative lung diseases.
KW - Bronchiectasis
KW - Chronic suppurative lung disease
KW - Lower airway infection
KW - Nontypeable Haemophilus influenzae
KW - Pneumococcal conjugate vaccine
KW - Protracted bacterial bronchitis
UR - http://www.scopus.com/inward/record.url?scp=85042352290&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2018.02.054
DO - 10.1016/j.vaccine.2018.02.054
M3 - Article
C2 - 29478754
AN - SCOPUS:85042352290
SN - 0264-410X
VL - 36
SP - 1736
EP - 1742
JO - Vaccine
JF - Vaccine
IS - 13
ER -