About

Brief study summary

The PNEU-CARE study took place between Oct. 2022 – Sept. 2023 and measured how much and which strains of Streptococcus pneumoniae and other respiratory bacteria (germs), including Staphylococcus aureus and group A Streptococcus, were carried in the nose and throat of healthy children in Navajo Nation and White Mountain Apache Tribal lands

 

Study background

Streptococcus pneumoniae or “Pneumo” is a germ that often lives in the nose of healthy people (this is called carriage). Other respiratory germs, including Staphylococcus aureus, group A Streptococcus, and Haemophilus influenzae, can live in the nose and throat along with Pneumo. Sometimes carriage of germs can lead to disease, including lung, brain, and blood infections.

  • By understanding carriage, we can get a better idea of which strains may go on to cause disease within the community.

Our main goal was to understand Pneumo carriage because Pneumo is such an important cause of disease among children. There are safe and effective vaccines that protect against disease caused by the most common strains of Pneumo.

  • At the time of this study, new vaccines (called PCV15 and PCV20) that protect against more strains of Pneumo had recently been licensed and approved for children.

 

What did we do?

This was a cross-sectional study, which means it took a snapshot of carriage at that moment in time.

  • Between Oct. 2022 to Sept. 2023, 500 children aged 7 months to 4 years were enrolled in Navajo Nation and White Mountain Apache Tribal lands.
  • Participation in the study was completely voluntary.
  • Once the child’s parent/legal guardian provided consent for them to participate, our study staff:
    • Collected two nasal swabs and one throat swab from the child.
    • Administered a survey to the parent/legal guardian to understand whether the child had any risk factors for respiratory disease.
    • Reviewed the child’s medical record.
  • The swabs were tested for Pneumo and other respiratory germs.

Key findings:

  • 68% of children tested positive for Pneumo. Many of the strains present are included in currently available pneumococcal vaccines.
  • 4% of children tested positive for Group A Streptococcus (Group A Strep) carriage in the back of the throat. This is similar to other settings.
  • 45% of children tested positive for Staphylococcus aureus (Staph). Staph was more often carried in the throat than the nose.

 

How will this help improve health in your community?

Indigenous communities in the US have a higher burden of Pneumo disease than the general population, even though vaccine coverage is high.

  • That’s why it’s important to make sure we know which strains of Pneumo are being carried and whether current vaccines are providing good protection from them.

The findings from this study can be used to advocate for vaccine policies and prevention efforts that reflect what’s going on with these germs locally.

 

Principal Investigator/Program Coordinator information

Catherine G. Sutcliffe: csutcli1@jhu.edu

 

Publications

  • Sutcliffe CG, Sergent VM, Azarian T, Becenti LR, Cella E, Honie EF, Johnston C, Pitalua J, Roessler K, Urdaneta-Páez V, Weatherholtz RC, Zylstra S, Hammitt LL. Pneumococcal Carriage Among Indigenous Children in the Southwest United States in 2022-2023. Pediatr Infect Dis J. 2026 Jan 1;45(1):89-95. doi: 10.1097/INF.0000000000005021.

 

Additional Information

For more information about these germs and the Pneumo vaccine can be found on the CDC’s website: