Skip to main content
Top
Published in: BMC Infectious Diseases 1/2008

Open Access 01-12-2008 | Research article

An individual-based network model to evaluate interventions for controlling pneumococcal transmission

Authors: Diana Karlsson, Andreas Jansson, Birgitta Henriques Normark, Patric Nilsson

Published in: BMC Infectious Diseases | Issue 1/2008

Login to get access

Abstract

Background

Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, but also a common colonizer of the upper respiratory tract. The emergence and spread of antibiotic resistant pneumococcal strains has threatened effective therapy. The long-term effects of measures aiming to limit pneumococcal spread are poorly understood. Computational modeling makes it possible to conduct virtual experiments that are impractical to perform in real life and thereby allows a more full understanding of pneumococcal epidemiology and control efforts.

Methods

We have developed a contact network model to evaluate the efficacy of interventions aiming to control pneumococcal transmission. Demographic data from Sweden during the mid-2000s were employed. Analyses of the model's parameters were conducted to elucidate key determinants of pneumococcal spread. Also, scenario simulations were performed to assess candidate control measures.

Results

The model made good predictions of previous findings where a correlation has been found between age and pneumococcal carriage. Of the parameters tested, group size in day-care centers was shown to be one of the most important factors for pneumococcal transmission. Consistent results were generated from the scenario simulations.

Conclusion

We recommend, based on the model predictions, that strategies to control pneumococcal disease and organism transmission should include reducing the group size in day-care centers.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mato R, Sanches IS, Simas C, Nunes S, Carrico JA, Sousa NG, Frazao N, Saldanha J, Brito-Avo A, Almeida JS, Lencastre HD: Natural history of drug-resistant clones of Streptococcus pneumoniae colonizing healthy children in Portugal. Microb Drug Resist. 2005, 11 (4): 309-322. 10.1089/mdr.2005.11.309.CrossRefPubMed Mato R, Sanches IS, Simas C, Nunes S, Carrico JA, Sousa NG, Frazao N, Saldanha J, Brito-Avo A, Almeida JS, Lencastre HD: Natural history of drug-resistant clones of Streptococcus pneumoniae colonizing healthy children in Portugal. Microb Drug Resist. 2005, 11 (4): 309-322. 10.1089/mdr.2005.11.309.CrossRefPubMed
2.
go back to reference Rey LC, Wolf B, Moreira JL, Milatovic D, Verhoef J, Farhat CK: Antimicrobial susceptibility and serotypes of nasopharyngeal Streptococcus pneumoniae in children with pneumonia and in children attending day-care centres in Fortaleza, Brazil. Int J Antimicrob Agents. 2002, 20 (2): 86-92. 10.1016/S0924-8579(02)00128-0.CrossRefPubMed Rey LC, Wolf B, Moreira JL, Milatovic D, Verhoef J, Farhat CK: Antimicrobial susceptibility and serotypes of nasopharyngeal Streptococcus pneumoniae in children with pneumonia and in children attending day-care centres in Fortaleza, Brazil. Int J Antimicrob Agents. 2002, 20 (2): 86-92. 10.1016/S0924-8579(02)00128-0.CrossRefPubMed
3.
go back to reference Arason VA, Gunnlaugsson A, Sigurdsson JA, Erlendsdottir H, Gudmundsson S, Kristinsson KG: Clonal spread of resistant pneumococci despite diminished antimicrobial use. Microb Drug Resist. 2002, 8 (3): 187-192. 10.1089/107662902760326896.CrossRefPubMed Arason VA, Gunnlaugsson A, Sigurdsson JA, Erlendsdottir H, Gudmundsson S, Kristinsson KG: Clonal spread of resistant pneumococci despite diminished antimicrobial use. Microb Drug Resist. 2002, 8 (3): 187-192. 10.1089/107662902760326896.CrossRefPubMed
4.
go back to reference Kyaw MH, Lynfield R, Schaffner W, Craig AS, Hadler J, Reingold A, Thomas AR, Harrison LH, Bennett NM, Farley MM, Facklam RR, Jorgensen JH, Besser J, Zell ER, Schuchat A, Whitney CG: Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med. 2006, 354 (14): 1455-1463. 10.1056/NEJMoa051642.CrossRefPubMed Kyaw MH, Lynfield R, Schaffner W, Craig AS, Hadler J, Reingold A, Thomas AR, Harrison LH, Bennett NM, Farley MM, Facklam RR, Jorgensen JH, Besser J, Zell ER, Schuchat A, Whitney CG: Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med. 2006, 354 (14): 1455-1463. 10.1056/NEJMoa051642.CrossRefPubMed
5.
go back to reference Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A: Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med. 2003, 348 (18): 1737-1746. 10.1056/NEJMoa022823.CrossRefPubMed Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A: Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med. 2003, 348 (18): 1737-1746. 10.1056/NEJMoa022823.CrossRefPubMed
6.
go back to reference Ekdahl K, Ahlinder I, Hansson HB, Melander E, Molstad S, Soderstrom M, Persson K: Duration of nasopharyngeal carriage of penicillin-resistant Streptococcus pneumoniae: Experiences from the south Swedish pneumococcal intervention project. Clinical Infectious Diseases. 1997, 25 (5): 1113-1117. 10.1086/516103.CrossRefPubMed Ekdahl K, Ahlinder I, Hansson HB, Melander E, Molstad S, Soderstrom M, Persson K: Duration of nasopharyngeal carriage of penicillin-resistant Streptococcus pneumoniae: Experiences from the south Swedish pneumococcal intervention project. Clinical Infectious Diseases. 1997, 25 (5): 1113-1117. 10.1086/516103.CrossRefPubMed
7.
go back to reference Sjostrom K, Blomberg C, Fernebro J, Dagerhamn J, Morfeldt E, Barocchi MA, Browall S, Moschioni M, Andersson M, Henriques F, Albiger B, Rappuoli R, Normark S, Henriques-Normark B: Clonal success of piliated penicillin nonsusceptible pneumococci. Proc Natl Acad Sci U S A. 2007, 104 (31): 12907-12912. 10.1073/pnas.0705589104.CrossRefPubMedPubMedCentral Sjostrom K, Blomberg C, Fernebro J, Dagerhamn J, Morfeldt E, Barocchi MA, Browall S, Moschioni M, Andersson M, Henriques F, Albiger B, Rappuoli R, Normark S, Henriques-Normark B: Clonal success of piliated penicillin nonsusceptible pneumococci. Proc Natl Acad Sci U S A. 2007, 104 (31): 12907-12912. 10.1073/pnas.0705589104.CrossRefPubMedPubMedCentral
8.
go back to reference Andersson M, Ekdahl K, Molstad S, Persson K, Hansson HB, Giesecke J: Modelling the spread of penicillin-resistant Streptococcus pneumoniae in day-care and evaluation of intervention. Stat Med. 2005, 24 (23): 3593-3607. 10.1002/sim.2199.CrossRefPubMed Andersson M, Ekdahl K, Molstad S, Persson K, Hansson HB, Giesecke J: Modelling the spread of penicillin-resistant Streptococcus pneumoniae in day-care and evaluation of intervention. Stat Med. 2005, 24 (23): 3593-3607. 10.1002/sim.2199.CrossRefPubMed
9.
go back to reference Huang SS, Finkelstein JA, Lipsitch M: Modeling community- and individual-level effects of child-care center attendance on pneumococcal carriage. Clin Infect Dis. 2005, 40 (9): 1215-1222. 10.1086/428580.CrossRefPubMed Huang SS, Finkelstein JA, Lipsitch M: Modeling community- and individual-level effects of child-care center attendance on pneumococcal carriage. Clin Infect Dis. 2005, 40 (9): 1215-1222. 10.1086/428580.CrossRefPubMed
10.
go back to reference Melegaro A, Gay NJ, Medley GF: Estimating the transmission parameters of pneumococcal carriage in households. Epidemiology and Infection. 2004, 132 (3): 433-441. 10.1017/S0950268804001980.CrossRefPubMedPubMedCentral Melegaro A, Gay NJ, Medley GF: Estimating the transmission parameters of pneumococcal carriage in households. Epidemiology and Infection. 2004, 132 (3): 433-441. 10.1017/S0950268804001980.CrossRefPubMedPubMedCentral
12.
go back to reference Hogberg L, Geli P, Ringberg H, Melander E, Lipsitch M, Ekdahl K: Age- and serogroup-related differences in observed durations of nasopharyngeal carriage of penicillin-resistant pneumococci. Journal of clinical microbiology. 2007, 45 (3): 948-952. 10.1128/JCM.01913-06.CrossRefPubMedPubMedCentral Hogberg L, Geli P, Ringberg H, Melander E, Lipsitch M, Ekdahl K: Age- and serogroup-related differences in observed durations of nasopharyngeal carriage of penicillin-resistant pneumococci. Journal of clinical microbiology. 2007, 45 (3): 948-952. 10.1128/JCM.01913-06.CrossRefPubMedPubMedCentral
13.
go back to reference Borres MP, Alestig K, Krantz I, Larsson P, Norvenius G, Stenqvist K: Carriage of penicillin-susceptible and non-susceptible pneumococci in healthy young children in Goteborg, Sweden. J Infect. 2000, 40 (2): 141-144.CrossRefPubMed Borres MP, Alestig K, Krantz I, Larsson P, Norvenius G, Stenqvist K: Carriage of penicillin-susceptible and non-susceptible pneumococci in healthy young children in Goteborg, Sweden. J Infect. 2000, 40 (2): 141-144.CrossRefPubMed
14.
go back to reference Kalin M: Bacteremic pneumococcal pneumonia: value of culture of nasopharyngeal specimens and examination of washed sputum specimens. Eur J Clin Microbiol. 1982, 1 (6): 394-396. 10.1007/BF02019941.CrossRefPubMed Kalin M: Bacteremic pneumococcal pneumonia: value of culture of nasopharyngeal specimens and examination of washed sputum specimens. Eur J Clin Microbiol. 1982, 1 (6): 394-396. 10.1007/BF02019941.CrossRefPubMed
15.
go back to reference Sandgren A, Sjostrom K, Olsson-Liljequist B, Christensson B, Samuelsson A, Kronvall G, Henriques Normark B: Effect of clonal and serotype-specific properties on the invasive capacity of Streptococcus pneumoniae. J Infect Dis. 2004, 189 (5): 785-796. 10.1086/381686.CrossRefPubMed Sandgren A, Sjostrom K, Olsson-Liljequist B, Christensson B, Samuelsson A, Kronvall G, Henriques Normark B: Effect of clonal and serotype-specific properties on the invasive capacity of Streptococcus pneumoniae. J Infect Dis. 2004, 189 (5): 785-796. 10.1086/381686.CrossRefPubMed
16.
go back to reference Söderström M: Respiratory tract infections in children. Aspects of etiology, incidence and recurrent infections . 1990, Lund, Sweden Söderström M: Respiratory tract infections in children. Aspects of etiology, incidence and recurrent infections . 1990, Lund, Sweden
22.
go back to reference Cauchemez S, Temime L, Valleron AJ, Varon E, Thomas G, Guillemot D, Boelle PY: S-pneumoniae transmission according to inclusion in conjugate vaccines: Bayesian analysis of a longitudinal follow-up in schools. Bmc Infectious Diseases. 2006, 6: Cauchemez S, Temime L, Valleron AJ, Varon E, Thomas G, Guillemot D, Boelle PY: S-pneumoniae transmission according to inclusion in conjugate vaccines: Bayesian analysis of a longitudinal follow-up in schools. Bmc Infectious Diseases. 2006, 6:
23.
go back to reference Kristinsson KG: Mathematical models as tools for evaluating the effectiveness of interventions: a comment on Levin. Clin Infect Dis. 2001, 33 Suppl 3: S174-9. 10.1086/321845.CrossRefPubMed Kristinsson KG: Mathematical models as tools for evaluating the effectiveness of interventions: a comment on Levin. Clin Infect Dis. 2001, 33 Suppl 3: S174-9. 10.1086/321845.CrossRefPubMed
24.
go back to reference Rosen C, Christensen P, Hovelius B, Prellner K: A longitudinal study of the nasopharyngeal carriage of pneumococci as related to pneumococcal vaccination in children attending day-care centres. Acta Otolaryngol. 1984, 98 (5-6): 524-532. 10.3109/00016488409107593.CrossRefPubMed Rosen C, Christensen P, Hovelius B, Prellner K: A longitudinal study of the nasopharyngeal carriage of pneumococci as related to pneumococcal vaccination in children attending day-care centres. Acta Otolaryngol. 1984, 98 (5-6): 524-532. 10.3109/00016488409107593.CrossRefPubMed
25.
go back to reference Dagan R, Melamed R, Muallem M, Piglansky L, Greenberg D, Abramson O, Mendelman PM, Bohidar N, Yagupsky P: Reduction of nasopharyngeal carriage of pneumococci during the second year of life by a heptavalent conjugate pneumococcal vaccine. J Infect Dis. 1996, 174 (6): 1271-1278.CrossRefPubMed Dagan R, Melamed R, Muallem M, Piglansky L, Greenberg D, Abramson O, Mendelman PM, Bohidar N, Yagupsky P: Reduction of nasopharyngeal carriage of pneumococci during the second year of life by a heptavalent conjugate pneumococcal vaccine. J Infect Dis. 1996, 174 (6): 1271-1278.CrossRefPubMed
26.
go back to reference O'Brien KL, Steinhoff MC, Edwards K, Keyserling H, Thoms ML, Madore D: Immunologic priming of young children by pneumococcal glycoprotein conjugate, but not polysaccharide, vaccines. Pediatr Infect Dis J. 1996, 15 (5): 425-430. 10.1097/00006454-199605000-00009.CrossRefPubMed O'Brien KL, Steinhoff MC, Edwards K, Keyserling H, Thoms ML, Madore D: Immunologic priming of young children by pneumococcal glycoprotein conjugate, but not polysaccharide, vaccines. Pediatr Infect Dis J. 1996, 15 (5): 425-430. 10.1097/00006454-199605000-00009.CrossRefPubMed
27.
go back to reference Mbelle N, Huebner RE, Wasas AD, Kimura A, Chang I, Klugman KP: Immunogenicity and impact on nasopharyngeal carriage of a nonavalent pneumococcal conjugate vaccine. J Infect Dis. 1999, 180 (4): 1171-1176. 10.1086/315009.CrossRefPubMed Mbelle N, Huebner RE, Wasas AD, Kimura A, Chang I, Klugman KP: Immunogenicity and impact on nasopharyngeal carriage of a nonavalent pneumococcal conjugate vaccine. J Infect Dis. 1999, 180 (4): 1171-1176. 10.1086/315009.CrossRefPubMed
28.
go back to reference Obaro SK, Adegbola RA, Banya WA, Greenwood BM: Carriage of pneumococci after pneumococcal vaccination. Lancet. 1996, 348 (9022): 271-272. 10.1016/S0140-6736(05)65585-7.CrossRefPubMed Obaro SK, Adegbola RA, Banya WA, Greenwood BM: Carriage of pneumococci after pneumococcal vaccination. Lancet. 1996, 348 (9022): 271-272. 10.1016/S0140-6736(05)65585-7.CrossRefPubMed
29.
go back to reference O'Brien KL, Millar EV, Zell ER, Bronsdon M, Weatherholtz R, Reid R, Becenti J, Kvamme S, Whitney CG, Santosham M: Effect of pneumococcal conjugate vaccine on nasopharyngeal colonization among immunized and unimmunized children in a community-randomized trial. J Infect Dis. 2007, 196 (8): 1211-1220. 10.1086/521833.CrossRefPubMed O'Brien KL, Millar EV, Zell ER, Bronsdon M, Weatherholtz R, Reid R, Becenti J, Kvamme S, Whitney CG, Santosham M: Effect of pneumococcal conjugate vaccine on nasopharyngeal colonization among immunized and unimmunized children in a community-randomized trial. J Infect Dis. 2007, 196 (8): 1211-1220. 10.1086/521833.CrossRefPubMed
30.
go back to reference Obaro S, Adegbola R: The pneumococcus: carriage, disease and conjugate vaccines. J Med Microbiol. 2002, 51 (2): 98-104.CrossRefPubMed Obaro S, Adegbola R: The pneumococcus: carriage, disease and conjugate vaccines. J Med Microbiol. 2002, 51 (2): 98-104.CrossRefPubMed
31.
go back to reference Henriques Normark B, Kalin M, Ortqvist A, Akerlund T, Liljequist BO, Hedlund J, Svenson SB, Zhou J, Spratt BG, Normark S, Kallenius G: Dynamics of penicillin-susceptible clones in invasive pneumococcal disease. J Infect Dis. 2001, 184 (7): 861-869. 10.1086/323339.CrossRefPubMed Henriques Normark B, Kalin M, Ortqvist A, Akerlund T, Liljequist BO, Hedlund J, Svenson SB, Zhou J, Spratt BG, Normark S, Kallenius G: Dynamics of penicillin-susceptible clones in invasive pneumococcal disease. J Infect Dis. 2001, 184 (7): 861-869. 10.1086/323339.CrossRefPubMed
32.
go back to reference Gray BM, Dillon HC, Briles DE: Epidemiological-Studies of Streptococcus-Pneumoniae in Infants - Development of Antibody to Phosphocholine. Journal of clinical microbiology. 1983, 18 (5): 1102-1107.PubMedPubMedCentral Gray BM, Dillon HC, Briles DE: Epidemiological-Studies of Streptococcus-Pneumoniae in Infants - Development of Antibody to Phosphocholine. Journal of clinical microbiology. 1983, 18 (5): 1102-1107.PubMedPubMedCentral
33.
go back to reference Feikin DR, Klugman KP, Facklam RR, Zell ER, Schuchat A, Whitney CG: Increased prevalence of pediatric pneumococcal serotypes in elderly adults. Clinical Infectious Diseases. 2005, 41 (4): 481-487. 10.1086/432015.CrossRefPubMed Feikin DR, Klugman KP, Facklam RR, Zell ER, Schuchat A, Whitney CG: Increased prevalence of pediatric pneumococcal serotypes in elderly adults. Clinical Infectious Diseases. 2005, 41 (4): 481-487. 10.1086/432015.CrossRefPubMed
Metadata
Title
An individual-based network model to evaluate interventions for controlling pneumococcal transmission
Authors
Diana Karlsson
Andreas Jansson
Birgitta Henriques Normark
Patric Nilsson
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2008
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-8-83

Other articles of this Issue 1/2008

BMC Infectious Diseases 1/2008 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.