Increase in fitness of Streptococcus pneumoniae is associated with the severity of necrotizing pneumonia
BACKGROUND: The incidence of necrotizing pneumococcal pneumonia has increased during the past 2 decades. We hypothesized that increased pneumococcal load or augmented inflammatory cytokine production might lead to destructive pneumococcal lung disease.
METHODS: This study enrolled prospectively 0- to 18-year-old children with a diagnosis of community-acquired pneumonia with pleural effusion admitted to 6 medical centers from March 2010 to April 2012. Children were diagnosed with pneumococcal empyema if the pleural fluid tested positive for quantitative pneumococcal (lytA) detection by real-time polymerase chain reaction. Pneumococcal empyema cases were further divided into 4 groups according to necrosis severity: (0) nonnecrosis, (1) mild necrosis, (2) cavitation and (3) bronchopleural fistula. Nasopharyngeal and pleural pneumococcal load, as well as levels of proinflammatory cytokines (TNF-α, IL-1β, IL-6, IL-8), Th1-(IL-2, IFN-γ), Th2-(IL-4, IL-10) and Th17-cytokines (IL-17), in the pleural fluid was measured.
RESULTS: Serotypes 19A and 3 accounted for 69.4% and 12.5%, respectively, of 72 cases of pneumococcal empyema. Pleural pneumococcal load was significantly higher in serotypes 19A and 3 infection than in the other strains causing infection (P = 0.006). There was a correlation between nasopharyngeal and pleural pneumococcal load (ρ = 0.35; P = 0.05). In multivariate ordinal logistic regression analysis, pleural pneumococcal load (adjusted odds ratio: 1.79; 95% confidence interval: 1.03-3.06) and IL-8 (adjusted odds ratio: 2.64; 95% confidence interval: 1.21-5.75) were independent factors associated with the severity of lung necrosis.
CONCLUSIONS: Evolution of Streptococcus pneumoniae toward increased fitness in their interaction with host and exaggerated IL-8 expression may be responsible for the increase of necrotizing pneumococcal pneumonia.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
The Pediatric infectious disease journal - 34(2015), 5 vom: 10. Mai, Seite 499-505 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hsieh, Yu-Chia [VerfasserIn] |
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| Anmerkungen: |
Date Completed 20.04.2016 Date Revised 25.11.2016 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/INF.0000000000000631 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM244155437 |
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| 100 | 1 | |a Hsieh, Yu-Chia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Increase in fitness of Streptococcus pneumoniae is associated with the severity of necrotizing pneumonia |
| 264 | 1 | |c 2015 | |
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| 500 | |a Date Revised 25.11.2016 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The incidence of necrotizing pneumococcal pneumonia has increased during the past 2 decades. We hypothesized that increased pneumococcal load or augmented inflammatory cytokine production might lead to destructive pneumococcal lung disease | ||
| 520 | |a METHODS: This study enrolled prospectively 0- to 18-year-old children with a diagnosis of community-acquired pneumonia with pleural effusion admitted to 6 medical centers from March 2010 to April 2012. Children were diagnosed with pneumococcal empyema if the pleural fluid tested positive for quantitative pneumococcal (lytA) detection by real-time polymerase chain reaction. Pneumococcal empyema cases were further divided into 4 groups according to necrosis severity: (0) nonnecrosis, (1) mild necrosis, (2) cavitation and (3) bronchopleural fistula. Nasopharyngeal and pleural pneumococcal load, as well as levels of proinflammatory cytokines (TNF-α, IL-1β, IL-6, IL-8), Th1-(IL-2, IFN-γ), Th2-(IL-4, IL-10) and Th17-cytokines (IL-17), in the pleural fluid was measured | ||
| 520 | |a RESULTS: Serotypes 19A and 3 accounted for 69.4% and 12.5%, respectively, of 72 cases of pneumococcal empyema. Pleural pneumococcal load was significantly higher in serotypes 19A and 3 infection than in the other strains causing infection (P = 0.006). There was a correlation between nasopharyngeal and pleural pneumococcal load (ρ = 0.35; P = 0.05). In multivariate ordinal logistic regression analysis, pleural pneumococcal load (adjusted odds ratio: 1.79; 95% confidence interval: 1.03-3.06) and IL-8 (adjusted odds ratio: 2.64; 95% confidence interval: 1.21-5.75) were independent factors associated with the severity of lung necrosis | ||
| 520 | |a CONCLUSIONS: Evolution of Streptococcus pneumoniae toward increased fitness in their interaction with host and exaggerated IL-8 expression may be responsible for the increase of necrotizing pneumococcal pneumonia | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Cytokines |2 NLM | |
| 700 | 1 | |a Chi, Hsin |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Kuang-Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Lai, Shen-Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Mu, Jung-Jung |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Kin-Sun |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Ching-Chuan |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yi-Chuan |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Hsiao-Chuan |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Luan-Yin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yhu-Chering |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Li-Min |e verfasserin |4 aut | |
| 700 | 0 | |a Taiwan Pediatric Infectious Diseases Alliance |e verfasserin |4 aut | |
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