Evaluation of differences in S. pneumoniae colonization among children with and without clinically diagnosed asthma/wheeze
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Streptococcus pneumoniae colonization is the nasopharynx is common in young children. Colonization of S. pneumoniae is a necessary precursor for invasive pneumococcal disease (IPD), which is a major cause of morbidity and mortality among children less than five years of age globally. Co-morbidities such as asthma have been identified as risk factors for IPD but little is known about why. Children with co-morbidities have a higher likelihood of progressing to IPD because they are colonized at higher rates or because their immune systems respond differently than children without co-morbidities. In addition, vaccination was introduced in 2010 to help decrease pneumococcal colonization rates from the 13 most common serotypes. We used data from the pediatric primary care clinic at Boston Medical Center to study the relationship between asthma/wheeze and S. pneumoniae colonization among children under the age of five years. Information about colonization serotype distribution was also assessed in this study. Data was accessed from 3098 children from 4–59 months old visiting the pediatric primary care clinic at Boston Medical Center from July 2010 to March 2014. In multivariable logistic regression models, the odds of colonization increased 80% (OR 1.80, 95% CI 1.2, 2.6) in children with asthma/wheeze under 24 months old. Adjustment for presence of URTI or recent exposure to antibiotics slightly mitigates this relationship. Children with clinically diagnosed asthma/wheeze have 80% increased odds of being colonized than children without asthma/wheeze.