Streptococcus pneumoniae acquisition among vaccinated Malaysian hajj pilgrims and its associated factors

Yıl 2017, Cilt: 07 Sayı: 02, 56 - 62, 01.06.2017

Nabilah İsmail, Nur Adlina Zainuddin, Zakuan Zainy Deris, Zaidah Abdul Rahman, Zeehaida Mohamed, Azian Harun, Siti Suraiya Md Noor, Nyi Nyi Naing, Aniza Abd Aziz, Habsah Hasan

https://doi.org/10.5799/jmid.vi.328784

Cited By: 2

Öz

Objective: To describe the acquisition of Streptococcus pneumoniae among Malaysian hajj pilgrims and to determine
the association with pneumococcal vaccination and respiratory symptoms.
Methods: This was a cross sectional study performed on Malaysian hajj pilgrims in a mass ritual gathering event
from October to November 2013 in Makkah. Demographic data and associated factors for the respiratory infection
were obtained by interview at Kota Bharu airport on their return. A sputum specimen or throat swab was taken from
all subjects for S. pneumoniae culture and antimicrobial susceptibility testing.
Results: S. pneumoniae was isolated in 1.81% (n=10, 95% CI 0.69, 2.93) out of 549 subjects. Fifty percent of them
(n=5) had received pneumococcal vaccination. Difficulty in breathing was significantly reduced in subjects without S.
pneumoniae isolation (p =0.042). In multivariable analysis, the uptake of pneumococcal vaccination was found to be
statistically significant in reducing S. pneumoniae acquisition (p =0.018) and those at a younger age were more liable
to acquire colonization or infection (p=0.018). Runny nose was significantly associated with the vaccinated group
(p=0.040).
Conclusion: The acquisition of S. pneumoniae among Malaysian hajj pilgrims in 2013 was significantly low with the
uptake of pneumococcal vaccination. J Microbiol Infect Dis 2017; 7(2):56-62 

Anahtar Kelimeler

Streptococcus pneumoniae, vaccinated, Malaysian, hajj pilgrims, associated factors

Kaynakça

• 1. Madani TA, Ghabrah TM, Al-Hedaithy MA, et al. Causes of hospitalization of pilgrims in the Hajj season of the Islamic year 1423 (2003). Ann Saudi Med 2006; 26(5):346-51.
• 2. Memish ZA, Assiri A, Almasri M, et al. Impact of the Hajj on pneumococcal transmission. Clin Microbiol Infect 2015; 21(1):77.e11-8.
• 3. Benkouiten S, Gautret P, Belhouchat K, et al. Acquisition of Streptococcus pneumoniae carriage in pilgrims during the 2012 Hajj. Clin Infect Dis 2014; 58(4):e106-9.
• 4. Benkouiten S, Charrel R, Belhouchat K, et al. Respiratory Viruses and Bacteria among Pilgrims during the 2013 Hajj. Emerging Infectious Diseases 2014; 20(11):1821-1827.
• 5. Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR 2010;59(No.34):1102- 6.
• 6. Pérez-Trallero E, Fernández-Mazarrasa C, García-Rey C, et al. Antimicrobial susceptibilities of 1,684 Streptococcus pneumoniae and 2,039 Streptococcus pyogenes isolates and their ecological relationships: results of a 1-year (1998- 1999) multicenter surveillance study in Spain. Antimicrob Agents Chemother 2001; 45 (12):3334- 40.
• 7. Felmingham D, White AR, Jacobs MR, et al. The Alexander Project: the benefits from a decade of surveillance. J Antimicrob Chemother 2005; 56 Suppl 2:ii3-ii21.
• 8. ABCs, Centers for Disease Control and Prevention. 2013. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Streptococcus pneumoniae, 2012. Available at: http://www.cdc.gov/abcs/reports findings/survreports/spneu12.pdf.
• 9. Kim SH, Song JH, Chung DR, et al. Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrob Agents Chemother 2012; 56(3):1418-26.
• 10. Abraham-Van Parijs, B. Review of pneumococcal conjugate vaccine in adults: implications on clinical development. Vaccine 2004; 22(11- 12):1362-71.
• 11. Tashani M, Barasheed O, Azeem M, et al. Pneumococcal Vaccine Uptake Among Australian Hajj pilgrims in 2011-13. Infect Disord Drug Targets 2014; 14(2):117-124.
• 12. Malaysian Clinical Practical Guidelines, Academy of Medicine of Malaysia. 2003. Clinical Practice Guidelines, Adult Vaccination. Available at http://www.acadmed.org.my/index.cfm?&menuid= 67. 2003. Accessed 17 May 2015.
• 13. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-first Informational Supplement M100-S21. CLSI, Wayne, PA, USA, 2011.
• 14. El-Sheikh SM, El-Assouli SM, Mohammed KA, Albar M. Bacteria and viruses that cause respiratory tract infections during the pilgrimage (Haj) season in Makkah, Saudi Arabia. Trop Med Int Health 1998; 3(3):205-9.
• 15. Alzeer AH. Respiratory tract infection during Hajj. Ann Thorac Med 2009; 4(2):50-3.
• 16. Asghar AH, Ashshi AM, Azhar EI, Bukhari SZ, Zafar TA, Momenah AM. Profile of bacterial pneumonia during Hajj. Indian J Med Res 2011; 133: 510-3.
• 17. Mandourah Y, Al-Radi A, Ocheltree AH, Ocheltree SR, Fowler RA. Clinical and temporal patterns of severe pneumonia causing critical illness during Hajj. BMC Infect Dis 2012; 12:117.
• 18. Memish ZA, Almasri M, Turkestani A, Al-Shangiti AM, Yezli S. Etiology of severe communityacquired pneumonia during the 2013 Hajj-part of the MERS-CoV surveillance program. International Journal of Infectious Diseases 2014; 25 (0):186-190.
• 19. Immunizations, C.V. Centers for Disease Control and Prevention. Last update February 2 2015. Vaccines and Immunizations, Vaccines and Preventable Diseases, Pneumococcal Vaccination:Who Needs It ? Retrieved 17 May 2015. Available at: http://www.cdc.gov/vaccines/vpdvac/pneumo/vacc-in-short.htm.
• 20. Zhang Y, Isaacman DJ, Wadowsky RM, Rydquist-White J, Post JC, Ehrlich GD. Detection of Streptococcus pneumoniae in whole blood by PCR. J Clin Microbiol 1995; 33(3):596-601.
• 21. Abd Aziz N., Hassan Y., Hashim H., Malik Mansoor S., Abd Shatar A.K.. PHP108 Pattern of Antibiotics Usage in Malaysian Hajj Pilgrim. Value Health 2012; 15(7):A626-A627.
• 22. Lysenko ES, Ratner AJ, Nelson AL, Weiser JN. The role of innate immune responses in the outcome of interspecies competition for colonization of mucosal surfaces. PLoS Pathog 2005; 1(1):e1.
• 23. Nuorti JP, Butler JC, Farley MM, et al. Cigarette Smoking and Invasive Pneumococcal Disease. N Engl J Med 2000; 342(10):681-689.
• 24. Rohani MY, Parasakthi N, Raudzah A, Yasim MY. In-vitro susceptibilities of Streptococcus pneumoniae strains isolated in Malaysia to six antibiotics. J Antimicrob Chemother 1999; 44(6):852-3.