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dc.contributor.authorHare, Kim M
dc.contributor.authorLeach, Amanda J
dc.contributor.authorSmith-Vaughan, Heidi C
dc.contributor.authorChang, Anne B
dc.contributor.authorGrimwood, Keith
dc.date.accessioned2018-03-26T04:02:44Z
dc.date.available2018-03-26T04:02:44Z
dc.date.issued2017
dc.identifier.issn8755-6863
dc.identifier.doi10.1002/ppul.23828
dc.identifier.urihttp://hdl.handle.net/10072/372362
dc.description.abstractStreptococcus pneumoniae (pneumococcus) is the main cause of bacterial pneumonia worldwide and has been studied extensively in this context. However, its role in chronic endobronchial infections and accompanying lower airway neutrophilic infiltration has received little attention. Severe and recurrent pneumonia are risk factors for chronic suppurative lung disease (CSLD) and bronchiectasis; the latter causes considerable morbidity and, in some populations, premature death in children and adults. Protracted bacterial bronchitis (PBB) is another chronic endobronchial infection associated with substantial morbidity. In some children, PBB may progress to bronchiectasis. Although nontypeable Haemophilus influenzae is the main pathogen in PBB, CSLD and bronchiectasis, pneumococci are isolated commonly from the lower airways of children with these diagnoses. Here we review what is known currently about pneumococci in PBB, CSLD and bronchiectasis, including the importance of pneumococcal nasopharyngeal colonization and how persistence in the lower airways may contribute to the pathogenesis of these chronic pulmonary disorders. Antibiotic treatments, particularly long‐term azithromycin therapy, are discussed together with antibiotic resistance and the impact of pneumococcal conjugate vaccines. Important areas requiring further investigation are identified, including immune responses associated with pneumococcal lower airway infection, alone and in combination with other respiratory pathogens, and microarray serotyping to improve detection of carriage and infection by multiple serotypes. Genome wide association studies of pneumococci from the upper and lower airways will help identify virulence and resistance determinants, including potential therapeutic targets and vaccine antigens to treat and prevent endobronchial infections. Much work is needed, but the benefits will be substantial.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherJohn Wiley & Sons
dc.relation.ispartofpagefrom1532
dc.relation.ispartofpageto1545
dc.relation.ispartofissue12
dc.relation.ispartofjournalPediatric Pulmonology
dc.relation.ispartofvolume52
dc.subject.fieldofresearchPaediatrics and Reproductive Medicine not elsewhere classified
dc.subject.fieldofresearchPaediatrics and Reproductive Medicine
dc.subject.fieldofresearchcode111499
dc.subject.fieldofresearchcode1114
dc.titleStreptococcus pneumoniae and chronic endobronchial infections in childhood
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorSmith-Vaughan, Heidi
gro.griffith.authorGrimwood, Keith


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