Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children.
A trial with a 7-valent pneumococcal-conjugate vaccine in children with recurrent acute otitis media showed a shift in pneumococcal colonisation towards non-vaccine serotypes and an increase in Staphylococcus aureus-related acute otitis media after vaccination. We investigated prevalence and determinants of nasopharyngeal carriage of Streptococcus pneumoniae and S aureus in 3198 healthy children aged 1-19 years. Nasopharyngeal carriage of S pneumoniae was detected in 598 (19%) children, and was affected by age (peak incidence at 3 years) and day-care attendance (odds ratio [OR] 2.14, 95% CI 1.44-3.18). S aureus carriage was affected by age (peak incidence at 10 years) and male sex (OR 1.46, 1.25-1.70). Serotyping showed 42% vaccine type pneumococci. We noted a negative correlation for co-colonisation of S aureus and vaccine-type pneumococci (OR 0.68, 0.48-0.94), but not for S aureus and non-vaccine serotypes. These findings suggest a natural competition between colonisation with vaccine-type pneumococci and S aureus, which might explain the increase in S aureus-related otitis media after vaccination.
Bogaert
D
D
Department of Paediatrics, Erasmus University Rotterdam, Rotterdam, Netherlands.
van Belkum
A
A
Sluijter
M
M
Luijendijk
A
A
de Groot
R
R
Rümke
H C
HC
Verbrugh
H A
HA
Hermans
P W M
PW
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000382:microbiology; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000382:microbiology; D022242:Pneumococcal Vaccines; D012008:Recurrence; D012016:Reference Values; D012703:Serotyping; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*
D022242:Pneumococcal Vaccines