Asthma is associated with increased <i>Streptococcus pneumoniae</i> carriage in the upper airway: a systematic review and meta-analysis
Bibliographic record
Abstract
Background Asthma is a chronic respiratory condition characterized by airway inflammation and hyperreactivity. Previous studies have suggested a potential association between asthma and bacterial colonization of the upper respiratory tract. This systematic review and meta-analysis aimed to compare bacterial carriage rates, specifically focusing on Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus, among individuals with and without asthma.Methods We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) in reporting this meta-analysis.Results A total of 619 records were initially identified, leading to the inclusion of eight studies that met predefined inclusion criteria. The pooled prevalence rates of bacterial carriage were analyzed using a fixed-effect model. The risk of bias assessment was conducted using the Newcastle-Ottawa Scale. A total of 5,399 subjects were included, comprising 1,572 (29.11%) individuals with asthma and 3,827 (70.88%) without asthma. The prevalence of S. pneumoniae carriage was significantly higher in individuals with asthma (30.8%, 95% CI: 19.5–42.1%) compared to those without (19.2%, 95% CI: 8.3–30%) with an odds ratio (OR) of 1.35 (95% CI: 1.10–1.66, p = 0.005; I2 = 29%). In contrast, H. influenzae carriage rates were similar between groups (18.6% in individuals with asthma vs. 21.4% with no asthma; OR = 0.93, p = 0.84; I2 = 0%). The prevalence of M. catarrhalis was low in individuals with asthma (4.7%), and the data for S. aureus was limited, showing a prevalence of 36.67% among individuals with asthma compared to 26.67% with no asthma.Conclusion This systematic review and meta-analysis showed that asthma may increase the risk of S. pneumoniae carriage. The similar carriage rates of H. influenzae between the two groups suggest distinct mechanisms of bacterial colonization, underscoring the need to further investigate asthma’s role in predisposing individuals to specific bacterial infections.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.047 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".