Publications by authors named "Esther German"

Longitudinal, community-based sampling is important for understanding prevalence and transmission of respiratory pathogens. Using a minimally invasive sampling method, the FAMILY Micro study monitored the oral, nasal and hand microbiota of families for 6 months. Here, we explore participant experiences and opinions.

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  • * Researchers used self-collected saliva and oropharyngeal/nasopharyngeal (OP/NP) samples to compare detection rates of the virus, finding good overall agreement between the two sample types but low rates of positive concordance, suggesting unique detection capabilities of each method.
  • * The findings highlight that HCW could inadvertently spread SARS-CoV-2 in hospital settings due to asymptomatic infections, emphasizing the need for routine testing to catch cases that symptom screening
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(pneumococcus) is the most commonly identified bacterial cause of pneumonia and the leading infectious cause of death in children under 5 years of age worldwide. Pneumococcal disease follows a seasonal pattern with increased incidence during winter. Pneumonia burden is also associated with poor air quality.

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  • - Recent research suggests that while pneumococci might increase COVID-19 risk, reports of co-infection in hospitalized patients are rare, possibly due to how these pathogens interact in the upper airway, affecting immune protection against SARS-CoV-2.
  • - The study examined health care workers and hospitalized patients to explore how the presence of Streptococcus pneumoniae impacts immune responses to SARS-CoV-2, particularly focusing on antiviral antibodies and cellular responses.
  • - Results indicated that pneumococcal colonization weakens immune defenses against SARS-CoV-2, particularly reducing levels of mucosal IgA in mild cases and affecting memory immune responses in more severe infections, raising concerns about potential immune evasion by other respiratory viruses as well
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Background: Household air pollution from solid fuels increases the risk of childhood pneumonia. Nasopharyngeal carriage of Streptococcus pneumoniae is a necessary step in the development of pneumococcal pneumonia. We aimed to assess the association between exposure to household air pollution and the prevalence and density of S pneumoniae carriage among children.

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Previous studies have suggested that the pneumococcal niche changes from the nasopharynx to the oral cavity with age. We use an Experimental Human Pneumococcal Challenge model to investigate pneumococcal colonisation in different anatomical niches with age. Healthy adults (n = 112) were intranasally inoculated with Streptococcus pneumoniae serotype 6B (Spn6B) and were categorised as young 18-55 years (n = 57) or older > 55 years (n = 55).

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Older adults are at increased risk of pneumococcal disease. This work aims to evaluate whether there is any decrease in serum IgG against variants of the antigens Pneumococcal surface protein A (PspA) and Pneumococcal surface protein C (PspC) in healthy adults with increasing age. Levels of IgG against PspA and PspC variants were determined by ELISA in serum samples comparing volunteers 18-30 years of age with volunteers who were 50-70+ before and after an experimental pneumococcal colonization challenge.

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Influenza virus infections affect millions of people annually, and current available vaccines provide varying rates of protection. However, the way in which the nasal microbiota, particularly established pneumococcal colonization, shape the response to influenza vaccination is not yet fully understood. In this study, we inoculated healthy adults with live Streptococcus pneumoniae and vaccinated them 3 days later with either tetravalent-inactivated influenza vaccine (TIV) or live attenuated influenza vaccine (LAIV).

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  • The study aimed to understand pneumococcal colonization and its immune effects in older adults (ages 50-84) since colonization is less common in this group but linked to high disease rates.
  • It involved inoculating 64 healthy participants with a specific pneumococcal strain, noting that 39% were successfully colonized, with higher rates in those aged 50-59 compared to those aged 70 and older.
  • Results showed that prior vaccination didn’t prevent colonization and that while colonization did increase antiprotein antibodies, it didn’t boost serotype-specific immunity like seen in younger adults, indicating different immune responses in older individuals.
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Background: Nasopharyngeal colonisation by S. pneumoniae is a prerequisite for invasive pneumococcal infections. Influenza co-infection leads to increased susceptibility to secondary pneumonia and mortality during influenza epidemics.

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  • Nasopharyngeal colonization by pathogens like Streptococcus pneumoniae is key for disease transmission and can lead to serious infections.
  • Deep nasopharyngeal swabbing is the standard method recommended by the World Health Organization for accurate detection of these bacteria, but it is uncomfortable for patients.
  • Research indicates that using nasal lining fluid filter strips can achieve the same level of sensitivity in detecting these pathogens, making it a more pleasant alternative.
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Streptococcus pneumoniae (Spn) is a common cause of respiratory infection, but also frequently colonizes the nasopharynx in the absence of disease. We used mass cytometry to study immune cells from nasal biopsy samples collected following experimental human pneumococcal challenge in order to identify immunological mechanisms of control of Spn colonization. Using 37 markers, we characterized 293 nasal immune cell clusters, of which 7 were associated with Spn colonization.

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Streptococcus pneumoniae is the main bacterial pathogen involved in pneumonia. Pneumococcal acquisition and colonization density is probably affected by viral co-infections, the local microbiome composition and mucosal immunity. Here, we report the interactions between live-attenuated influenza vaccine (LAIV), successive pneumococcal challenge, and the healthy adult nasal microbiota and mucosal immunity using an experimental human challenge model.

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The demographics and comorbidities of patients with community acquired pneumonia (CAP) vary enormously but stratified treatment is difficult because aetiological studies have failed to comprehensively identify the pathogens. Our aim was to describe the bacterial microbiota of CAP and relate these to clinical characteristics in order to inform future trials of treatment stratified by co-morbidity. CAP patients were prospectively recruited at two UK hospitals.

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Pneumococcal colonization is rarely studied in adults, except as part of family surveys. We report the outcomes of colonization screening in healthy adults (all were nonsmokers without major comorbidities or contact with children aged <5 years) who had volunteered to take part in clinical research. Using nasal wash culture, we detected colonization in 6.

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Background: Streptococcus pneumoniae is an intermittent commensal organism in the nasopharynx. Colonisation is a prerequisite for disease and malnourished children are especially susceptible to severe infection. This systematic review examines published prevalence rates of pneumococcal colonisation in the upper respiratory tract of chronically malnourished children <5 y of age.

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Colonization of the upper respiratory tract by pneumococcus is important both as a determinant of disease and for transmission into the population. The immunological mechanisms that contain pneumococcus during colonization are well studied in mice but remain unclear in humans. Loss of this control of pneumococcus following infection with influenza virus is associated with secondary bacterial pneumonia.

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Background: The incidence of community-acquired pneumonia and lower respiratory tract infection rises considerably in later life. Immunoglobulin M (IgM) antibody levels to pneumococcal capsular polysaccharide are known to decrease with age; however, whether levels of IgM antibody to pneumococcal proteins are subject to the same decline has not yet been investigated.

Methods: This study measured serum levels and binding capacity of IgM antibody specific to the pneumococcal surface protein A (PspA) and an unencapsulated pneumococcal strain in serum isolated from hospital patients aged < 60 and ≥ 60, with and without lower respiratory tract infection.

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Current vaccines against , a bacterial species that afflicts people by causing a wide spectrum of diseases, do not protect against all pneumococcal serotypes. Thus, alternative vaccines to fight pneumococcal infections that target common proteins are under investigation. One promising strategy is to take advantage of immune cross-reactivity between commensal and pathogenic microbes for cross-protection.

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