Upper respiratory tract colonization with Streptococcus pneumoniae in adults

Adriano Arguedas, Krzysztof Trzciński, Katherine L. O’Brien, Daniela M. Ferreira, Anne L. Wyllie, Daniel Weinberger, Leon Danon, Stephen I. Pelton, Chiara Azzari, Laura L. Hammitt, Raquel Sá-Leão, Maria Cristina C. Brandileone, Samir Saha, Jose Suaya, Raul Isturiz, Luis Jodar, Bradford D. Gessner

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)


Introduction: Most of the current evidence regarding pneumococcal upper respiratory colonization in adults suggests that despite high disease burden, carriage prevalence is low. Contemporary studies on adult pneumococcal colonization have largely followed the pediatric approach by which samples are obtained mostly from the nasopharynx and bacterial detection is evaluated by routine culture alone. Recent evidence suggests that the ‘pediatric approach’ may be insufficient in adults and pneumococcal detection in this population may be improved by longitudinal studies that include samples from additional respiratory sites combined with more extensive laboratory testing. Areas covered: In this article, relevant literature published in peer review journals on adult pneumococcal colonization, epidemiology, detection methods, and recommendations were reviewed. Expert opinion: Respiratory carriage of Streptococcus pneumoniae has been underestimated in adults. Contemporary pneumococcal carriage studies in adults that collect samples from alternative respiratory sites such as the oropharynx, saliva, or nasal wash; are culture-enriched for pneumococcus; and use molecular diagnostic methods designed to target two pneumococcal DNA sequences should enhance pneumococcal detection in the adult respiratory tract. This finding may have implications for the interpretation of dynamics of pneumococcal transmission and vaccination.

Original languageEnglish
Pages (from-to)353-366
Number of pages14
JournalExpert Review of Vaccines
Issue number4
Publication statusPublished - 2 Apr 2020


  • Adults
  • carriage
  • colonization
  • pneumococcal
  • Streptococcus pneumoniae
  • upper respiratory tract


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