title: Nasopharyngeal microbial interactions in the era of pneumococcal conjugate vaccination.
abstract: The nasopharynx of children is often colonised by microorganisms such as Streptococcus pneumoniae (the pneumococcus) that can cause infections including pneumonia and otitis media. In this complex environment, bacteria and viruses may impact each other through antagonistic as well as synergistic interactions. Vaccination may alter colonisation dynamics, evidenced by the rise in non-vaccine serotypes following pneumococcal conjugate vaccination. Discovery of an inverse relationship between S. pneumoniae and Staphylococcus aureus carriage generated concern that pneumococcal vaccination could increase S. aureus carriage and disease. Here we review data on co-colonisation of pathogens in the nasopharynx, focusing on S. pneumoniae and the impact of pneumococcal vaccination. Thus far, pneumococcal vaccination has not had a sustained impact on S. aureus carriage but it is associated with an increase in non-typeable Haemophilus influenzae in acute otitis media aetiology. Advances in bacterial and viral detection methodologies have facilitated research in nasopharyngeal microbiology and will aid investigation of potential vaccine-induced changes, particularly when baseline studies can be conducted prior to pneumococcal vaccine introduction.
authors.affiliation: Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. eileen.dunne@mcri.edu.au
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Dunne
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Smith-Vaughan
authors.forename: Roy M
authors.initials: RM
authors.lastname: Robins-Browne
authors.forename: E Kim
authors.initials: EK
authors.lastname: Mulholland
authors.forename: Catherine
authors.initials: C
authors.lastname: Satzke
mesh_terms: D002353:Carrier State / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D006193:Haemophilus influenzae / Q000254:growth & development / Q000276:immunology; D006801:Humans; D056265:Microbial Interactions; D009305:Nasopharynx / Q000276:immunology / Q000382:microbiology*; D010033:Otitis Media / Q000382:microbiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000254:growth & development* / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000254:growth & development* / Q000276:immunology; D014611:Vaccination
chemical_list: D022242:Pneumococcal Vaccines