Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children

• Published in: The Lancet (British edition) Vol. 363; no. 9424; pp. 1871 - 1872
• Main Authors: Bogaert, D, van Belkum, A, Sluijter, M, Luijendijk, A, de Groot, R, Rümke, HC, Verbrugh, HA, Hermans, PWM
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 05.06.2004; Lancet; Elsevier Limited
• Subjects: Acute Disease; Adolescent; Adult; Bacteria; Biological and medical sciences; Carrier State - microbiology; Child; Child Day Care Centers; Child, Preschool; Children; Children & youth; Clinical trials; Colonization; Female; General aspects; Health risk assessment; Humans; Immune system; Immunization; Incidence; Infant; Male; Medical sciences; Nasopharynx - microbiology; Otitis media; Pneumococcal Infections - microbiology; Pneumococcal Vaccines; Pneumonia; Recurrence; Reference Values; Regression analysis; Serotypes; Serotyping; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - isolation & purification; Vaccination; Vaccines; Denmark; Netherlands; Human; Healthy subject; Streptococcus pneumoniae; Infection; Medicine; Streptococcaceae; Streptococcal infection; Bacteriosis; Bacteria; Micrococcales; Micrococcaceae; Carrier; Staphylococcal infection; Child; Pneumococcal infection; Colonization; Staphylococcus aureus
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(04)16357-5

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.