Pneumococci and related infections globally and in Sweden

In the Biopneumo study we investigate if patients with pneumococcal invasive disease, i.e. patients with bacteria infecting the blood stream or any other sterile compartment of the body, have defects in their immune responses. We further determine bacterial factors associated with the disease, if viral coinfection has any impact on disease outcome, and how pneumococcal bacteria modulate immune responses.

Adult patients with invasive pneumococcal disease are identified at microbiological laboratories in the Region Västra Götaland, and included while still in the hospital or soon after discharge. The patients are sampled during disease for assessment of immunoglobulin levels, and for analysis of polymorphisms in genes involved in immune responses. A sample is also taken for determination of viral coinfection. After two months the patients return and donate blood for assessments of phagocyte function, lymphocyte populations and immunoglobulins. Clinical data including risk factors, manifestations and outcome are collected. Virulence traits in the pneumococcal strains are determined by genome sequencing methods. In vitro experiments analyze microRNA and surface protein expression in monocytes stimulated by pneumococcal bacteria.

We expect to identify new risk groups in need of immunological investigations and/or preventions, such as vaccination or immunoglobulin substitution. We further expect to find many patients with undiscovered immune deficiencies or underlying conditions that need special care.

There is a high misuse of antibiotics in sub-Saharan Africa leading to high rates of antimicrobial resistance in bacteria causing common infections in the child population. In the Democratic Republic of Congo we qualitatively explore behavior patterns among mothers to young children, among antibiotic providers and among health care professionals in the primary health care level on the use of antibiotics in children. The project will guide implementations aiming to improve the rational use of antibiotics in DR Congo and hence reduce the level of antimicrobial resistance in the community.