title: Nasopharyngeal carriage of individual Streptococcus pneumoniae serotypes during pediatric pneumonia as a means to estimate serotype disease potential.
abstract: BACKGROUND
  We aimed at estimating pneumococcal serotype-specific disease potential in pediatric community-acquired alveolar pneumonia (CAAP), by comparing nasopharyngeal pneumococcal carriage during disease to carriage in healthy children.
  
  
  METHODS
  Pneumococcal nasopharyngeal cultures were obtained from children < 5 years old admitted to the emergency room or hospitalized with radiologically diagnosed CAAP and from healthy controls. Disease potential was estimated by calculating serotype-specific odds ratios (OR) of a given serotype to be carried during disease compared with healthy children (after adjustment for age, ethnicity, previous antibiotic therapy, and season).
  
  
  RESULTS
  A total of 603 and 1504 isolates were obtained from CAAP and healthy children, respectively. A significant OR > 1.0 of a specific serotype being carried during disease (suggesting a higher disease potential) was observed with serotypes (by decreasing rank) 1, 5, 22F, 7F, 14, 9V, and 19A. A significant OR < 1.0 of being carried during disease (suggesting a lower disease potential) was observed with serotypes 6A, 6B, 23A, and 35B. Carriage of PCV7 serotypes (grouped) during CAAP was highest in age group 6 to 17 months. PCV10 and PCV13 provided significantly higher coverage for both 6 to 17 and 18 to 35 month age groups.
  
  
  CONCLUSIONS
  It is suggested that serotypes 1, 5, 7F, 9V, 14, 19A, and 22F have a higher disease potential for childhood pneumonia than do serotypes 6A, 6B, 23A, and 35B.
authors.affiliation: The Pediatric Infectious Disease Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. dudi@bgu.ac.il
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: Nitza
authors.initials: N
authors.lastname: Newman
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar-Ziv
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
mesh_terms: D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000382:microbiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009305:Nasopharynx / Q000382:microbiology*; D011018:Pneumonia, Pneumococcal / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity*