Epidemiological studies of Streptococcus pneumoniae carriage in the post-vaccination era among two risk groups: children and the elderly

Dissertation presented to obtain the Ph.D. degree in Biology/ Molecular BiologyStreptococcus pneumoniae is a global cause of disease including pneumonia, otitis media, conjunctivitis, sepsis, and bacterial meningitis. These infections are not essential to the transmission or long-term survival of the bacterium; indeed, S. pneumoniae depends on asymptomatic colonization of the human nasopharynx for its dissemination to additional hosts. Considering this, colonization studies are a good way to monitor changes in the pneumococcal epidemiology that may result from the use of antibiotics and vaccines. The molecular characterization of pneumococci is crucial to assess these changes which highlight the need for the development and validation of easier and faster methods of molecular typing. Since 1996 our group has been monitoring the pneumococcal population colonizing children attending day care centers. However, for several years these studies have been confined to the Lisbon area. In this PhD we have addressed this situation by including other regions of Portugal in our study. In addition, we have started to study pneumococcal colonization in the elderly, the other age group where the incidence of pneumococcal infections is high. This thesis summarizes five studies conducted during this PhD. The first four studies were focused on the pneumococcal epidemiology among the two age groups where the rates of pneumococcal disease are highest: children up to six years old and adults older than 60 years. The fifth and last study describes the evaluation and validation of a new genotyping strategy for pneumococci.(...)Financial support from Fundação para a Ciência e a Tecnologia, Portugal through grant SFRH/BD/40706/2007 awarded to Sónia Nunes