Previous unknown haematological malignancy or immune deficiency in patients with invasive pneumococcal infection

In the Biopneumo study, the research group determines immunological characteristics and potential underlying immune deficiencies in patients with pneumococcal invasive disease, i.e. patients with bacteria infecting the blood stream or any other sterile compartment of the body. The group also assesses 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 at hospital or soon after discharge. The patients are sampled during disease, in the convalescence phase, or at both occasions, for assessment of immunoglobulin levels, complement, phagocyte function, lymphocyte populations and for analysis of polymorphisms in genes involved in immune responses. A sample is also taken during disease for analysis of a respiratory viral coinfection. Clinical data including risk factors, manifestations and outcomes are collected. Virulence traits in the pneumococcal strains are determined by whole genome sequencing. In vitro experiments analyse microRNA and surface protein expression in monocytes stimulated by pneumococcal bacteria.

Following the results of the Biopneumo study, a larger, prospective study has been initiated in Region Västra Götalands and Region Örebro County. The aim is to confirm if patients with invasive pneumococcal disease is a high-risk population for haematological malignancy and therefore should be screened for early detection of such cancer. The aim is further to identify those individuals in need of immunoglobulin substitution therapy due to severe deficiency with risk of lethal bacterial infections. In the study patients with severe pneumococcal infections are compared with those having bacteraemia caused by other bacteria (staphylococci) and healthy controls. 

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 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.