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Sampling methods for the study of pneumococcal carriage: a systematic review

Sampling methods for the study of pneumococcal carriage: a systematic review
Sampling methods for the study of pneumococcal carriage: a systematic review
Streptococcus pneumoniae is an important pathogen worldwide. Accurate sampling of S. pneumoniae carriage is central to surveillance studies before and following conjugate vaccination programmes to combat pneumococcal disease. Any bias introduced during sampling will affect downstream recovery and typing. Many variables exist for the method of collection and initial processing, which can make inter-laboratory or international comparisons of data complex. In February 2003, a World Health Organisation working group published a standard method for the detection of pneumococcal carriage for vaccine trials to reduce or eliminate variability. We sought to describe the variables associated with the sampling of S. pneumoniae from collection to storage in the context of the methods recommended by the WHO and those used in pneumococcal carriage studies since its publication. A search of published literature in the online PubMed database was performed on the 1st June 2012, to identify published studies that collected pneumococcal carriage isolates, conducted after the publication of the WHO standard method. After undertaking a systematic analysis of the literature, we show that a number of differences in pneumococcal sampling protocol continue to exist between studies since the WHO publication. The majority of studies sample from the nasopharynx, but the choice of swab and swab transport media is more variable between studies. At present there is insufficient experimental data that supports the optimal sensitivity of any standard method. This may have contributed to incomplete adoption of the primary stages of the WHO detection protocol, alongside pragmatic or logistical issues associated with study design. Consequently studies may not provide a true estimate of pneumococcal carriage. Optimal sampling of carriage could lead to improvements in downstream analysis and the evaluation of pneumococcal vaccine impact and extrapolation to pneumococcal disease control therefore further in depth comparisons would be of value
6738-6744
Gladstone, R.A.
c75d747c-0663-49e3-8d81-4e797eb79d0a
Jefferies, J.M.
9468e292-0b41-412d-9470-944e257c7bcf
Faust, S.N.
f97df780-9f9b-418e-b349-7adf63e150c1
Clarke, S.C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Gladstone, R.A.
c75d747c-0663-49e3-8d81-4e797eb79d0a
Jefferies, J.M.
9468e292-0b41-412d-9470-944e257c7bcf
Faust, S.N.
f97df780-9f9b-418e-b349-7adf63e150c1
Clarke, S.C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17

Gladstone, R.A., Jefferies, J.M., Faust, S.N. and Clarke, S.C. (2012) Sampling methods for the study of pneumococcal carriage: a systematic review. Vaccine, 30 (48), 6738-6744. (doi:10.1016/j.vaccine.2012.08.080). (PMID:22981760)

Record type: Article

Abstract

Streptococcus pneumoniae is an important pathogen worldwide. Accurate sampling of S. pneumoniae carriage is central to surveillance studies before and following conjugate vaccination programmes to combat pneumococcal disease. Any bias introduced during sampling will affect downstream recovery and typing. Many variables exist for the method of collection and initial processing, which can make inter-laboratory or international comparisons of data complex. In February 2003, a World Health Organisation working group published a standard method for the detection of pneumococcal carriage for vaccine trials to reduce or eliminate variability. We sought to describe the variables associated with the sampling of S. pneumoniae from collection to storage in the context of the methods recommended by the WHO and those used in pneumococcal carriage studies since its publication. A search of published literature in the online PubMed database was performed on the 1st June 2012, to identify published studies that collected pneumococcal carriage isolates, conducted after the publication of the WHO standard method. After undertaking a systematic analysis of the literature, we show that a number of differences in pneumococcal sampling protocol continue to exist between studies since the WHO publication. The majority of studies sample from the nasopharynx, but the choice of swab and swab transport media is more variable between studies. At present there is insufficient experimental data that supports the optimal sensitivity of any standard method. This may have contributed to incomplete adoption of the primary stages of the WHO detection protocol, alongside pragmatic or logistical issues associated with study design. Consequently studies may not provide a true estimate of pneumococcal carriage. Optimal sampling of carriage could lead to improvements in downstream analysis and the evaluation of pneumococcal vaccine impact and extrapolation to pneumococcal disease control therefore further in depth comparisons would be of value

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Published date: 6 November 2012
Organisations: Faculty of Medicine

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Local EPrints ID: 348148
URI: http://eprints.soton.ac.uk/id/eprint/348148
PURE UUID: e9a574db-4c92-4111-9e74-3f5c5e270f30
ORCID for S.N. Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for S.C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 07 Feb 2013 13:51
Last modified: 18 Feb 2021 17:08

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Contributors

Author: R.A. Gladstone
Author: J.M. Jefferies
Author: S.N. Faust ORCID iD
Author: S.C. Clarke ORCID iD

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