{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:21:18Z","timestamp":1791141678289,"version":"4.1.0"},"reference-count":47,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,7,24]]},"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      A high genomic load of\n                      <jats:italic>Pneumococcus<\/jats:italic>\n                      from blood or cerebrospinal fluid has been associated with increased mortality. We aimed to analyse whether nasopharyngeal colonisation density in HIV-infected patients with community-acquired pneumonia (CAP) is associated with markers of disease severity or poor outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Quantitative\n                      <jats:italic>lytA<\/jats:italic>\n                      real-time PCR was performed on nasopharyngeal swabs in HIV-infected South African adults hospitalised for acute CAP at Chris Hani Baragwanath Hospital, Soweto, South Africa. Pneumonia aetiology was considered pneumococcal if any sputum culture or Gram stain, urinary pneumococcal C-polysaccharide-based antigen, blood culture or whole blood\n                      <jats:italic>lytA<\/jats:italic>\n                      real-time PCR revealed pneumococci.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was a moderate correlation between the mean nasopharyngeal colonisation densities and increasing CURB65 scores among all-cause patients with pneumonia (Spearman correlation coefficient r=0.15, p=0.06) or with the Pitt bacteraemia score among patients with pneumococcal bacteraemia (p=0.63). In patients with pneumococcal pneumonia, nasopharyngeal pneumococcal colonisation density was higher among non-survivors than survivors (7.7 vs 6.1 log\n                      <jats:sub>10<\/jats:sub>\n                      copies\/mL, respectively, p=0.02) and among those who had pneumococci identified from blood cultures and\/or by whole blood\n                      <jats:italic>lytA<\/jats:italic>\n                      real-time PCR than those with non-bacteraemic pneumococcal pneumonia (6.6 vs 5.6 log\n                      <jats:sub>10<\/jats:sub>\n                      copies\/mL, p=0.03). Nasopharyngeal colonisation density correlated positively with the biomarkers procalcitonin (Spearman correlation coefficient r=0.37, p&lt;0.0001), proadrenomedullin (r=0.39, p=0.008) and copeptin (r=0.30, p=0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In addition to its previously reported role as a diagnostic tool for pneumococcal pneumonia, quantitative nasopharyngeal colonisation density also correlates with mortality and prognostic biomarkers. It may also be useful as a severity marker for pneumococcal pneumonia in HIV-infected adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-005953","type":"journal-article","created":{"date-parts":[[2014,8,12]],"date-time":"2014-08-12T01:42:30Z","timestamp":1407807750000},"page":"e005953","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Pneumococcal colonisation density: a new marker for disease severity in HIV-infected adults with pneumonia"],"prefix":"10.1136","volume":"4","author":[{"given":"Werner C","family":"Albrich","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, St Gallen, Switzerland"},{"name":"Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South 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Niekerk","sequence":"additional","affiliation":[{"name":"Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Noel","family":"Telles","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Laboratory, Fondation M\u00e9rieux, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Ebrahim","sequence":"additional","affiliation":[{"name":"Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melina","family":"Messaoudi","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Laboratory, Fondation M\u00e9rieux, Lyon, 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