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Nasal carriage of Streptococcus pneumoniae serotypes and Staphylococcus aureus in Streptococcus pneumoniae-vaccinated and non-vaccinated young children

  • N. H. T. M. DUKERS-MUIJRERS (a1) (a2), E. STOBBERINGH (a2), P. BEISSER (a2), R. C. H. BOESTEN (a1), P. JACOBS (a3) and C. J. P. A. HOEBE (a1) (a2)...

Since the implementation of Streptococcus pneumoniae (SPn) conjugate vaccination (PCV), non-vaccine types have prevailed in invasive pneumococcal disease (IPD), and an increase in Staphylococcus aureus (SA) burden has been suggested. Here, we assess the epidemiology of SA and SPn nasal carriage in 620 children at day-care centres; 141 of these children had received 1–4 PCV7 doses. A higher vaccine dosage was associated with non-vaccine-type SPn carriage. Of all SPn isolates, 45% were PCV7 types, 1% were additional PCV10 types and 22% were the three additional PCV13 types. SA carriage was inversely associated with vaccine-type SPn carriage. SPn serotype 19A showed higher SA co-carriage rates compared to other SPn serotypes. PCV7 implementation does not prevent children from being part of the IPD-related SPn transmission chain. These results contribute to the monitoring of SA- and SPn-related disease and add to the debate on the current national vaccination policy that recently included a change from PCV7 to PCV10.

Corresponding author
*Author for correspondence: Dr N. H. T. M. Dukers-Muijrers, Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, P.O. Box 2022, 6160 HA Geleen, The Netherlands. (Email:
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1. KL O'Brien , Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet 2009; 374: 893902.

2. SB Black , Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia. Pediatric Infectious Disease Journal 2002; 21: 810815.

3. J Hansen , Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than 5 years of age for prevention of pneumonia: updated analysis using World Health Organization standardized interpretation of chest radiographs. Pediatric Infectious Disease Journal 2006; 25: 779781.

4. KP Klugman , A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. New England Journal of Medicine 2003; 349: 13411348.

5. MG Lucero , Efficacy of an 11-valent pneumococcal conjugate vaccine against radiologically confirmed pneumonia among children less than 2 years of age in the Philippines: a randomized, double-blind, placebo-controlled trial. Pediatric Infectious Disease Journal 2009; 28: 455462.

6. GD Rodenburg , Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands. Emerging Infectious Diseases 2010; 16: 816823.

7. DJ Isaacman , ED McIntosh , RR Reinert . Burden of invasive pneumococcal disease and serotype distribution among Streptococcus pneumoniae isolates in young children in Europe: impact of the 7-valent pneumococcal conjugate vaccine and considerations for future conjugate vaccines. International Journal of Infectious Diseases 2009; 14: e197209.

8. Q Xu , Novel type of Streptococcus pneumoniae causing multidrug-resistant acute otitis media in children. Emerging Infectious Diseases 2009; 15: 547– 551.

9. TQ Tan . Antibiotic resistant infections due to Streptococcus pneumoniae: impact on therapeutic options and clinical outcome. Current Opinion in Infectious Diseases 2003; 16: 271277.

10. WP Hanage , Evidence that pneumococcal serotype replacement in Massachusetts following conjugate vaccination is now complete. Epidemics 2010; 2: 8084.

11. D Bogaert , Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children. Lancet 2004; 363: 18711872.

12. G Regev-Yochay , Association between carriage of Streptococcus pneumoniae and Staphylococcus aureus in Children. Journal of the American Medical Association 2004; 292: 716720.

13. B Quintero , Epidemiology of Streptococcus pneumoniae and Staphylococcus aureus colonization in healthy Venezuelan children. European Journal of Clinical Microbiology Infectious Diseases 2011; 30: 719.

14. LM McNally , Lack of association between the nasopharyngeal carriage of Streptococcus pneumoniae and Staphylococcus aureus in HIV-1-infected South African children. Journal of Infectious Diseases 2006; 194: 385390.

15. EJM van Gils , Effect of seven-valent pneumococcal conjugate vaccine on Staphylococcus aureus colonisation in a randomised controlled trial. PLoS ONE 2011; 6: e20229.

16. MB Rothberg , SD Haessler , RB Brown . Complications of viral influenza. American Journal of Medicine 2008; 121: 258264.

17. GM Lee , Epidemiology and risk factors for Staphylococcus aureus colonization in children in the post-PCV7 era. BMC Infectious Diseases 2009; 9: 110.

18. P Jacoby , Modelling the co-occurrence of Streptococcus pneumoniae with other bacterial and viral pathogens in the upper respiratory tract. Vaccine 2007;25: 24582464.

19. EJ van Gils , Effect of reduced-dose schedules with 7-valent pneumococcal conjugate vaccine on nasopharyngeal pneumococcal carriage in children: a randomized controlled trial. Journal of the American Medical Association 2009; 302: 159167.

20. DM Weinberger , R Malley , M Lipsitch . Serotype replacement in disease after pneumococcal vaccination. Lancet 2011; 378: 19621973.

21. AG Jansen , Invasive pneumococcal disease in the Netherlands: Syndromes, outcome and potential vaccine benefits. Vaccine 2009; 27: 23942401.

22. EJ van Gils , Pneumococcal conjugate vaccination and nasopharyngeal acquisition of pneumococcal serotype 19A strains. Journal of the American Medical Association 2010; 304: 10991106.

23. J Spijkerman , Carriage of Streptococcus pneumoniae 3 years after start of vaccination program, the Netherlands. Emerging Infectious Diseases 2011; 17: 584591.

24. DM Weinberger , Association of serotype with risk of death due to pneumococcal pneumonia: a meta-analysis. Clinical Infectious Diseases 2010; 51: 692699.

25. KE Elberse , Seroprevalence of IgG antibodies against 13 vaccine Streptococcus pneumoniae serotypes in the Netherlands. Vaccine 2010; 29: 10291035.

26. G Regev-Yochay , The pneumococcal pilus predicts the absence of Staphylococcus aureus co-colonization in pneumococcal carriers. Clinical Infectious Diseases 2009; 48: 760763.

27. DC Melles , Nasopharyngeal co-colonization with Staphylococcus aureus and Streptococcus pneumoniae in children is bacterial genotype independent. Microbiology 2007; 153: 686692.

28. A Lebon , The inverse correlation between Staphylococcus aureus and Streptococcus pneumoniae colonization in infants is not explained by differences in serum antibody levels in the Generation R Study. Clinical and Vaccine Immunology 2011; 18: 180183.

29. A Basset , Association of the pneumococcal pilus with certain capsular serotypes but not with increased virulence. Journal of Clinical Microbiology 2007; 45: 16841689.

30. DM Weinberger , Pneumococcal capsular polysaccharide structure predicts serotype prevalence. PLoS Pathogens 2009; 5: e1000476.

32. PR Paradiso . Advances in pneumococcal disease prevention: 13-valent pneumococcal conjugate vaccine for infants and children. Clinical Infectious Diseases 2011; 52: 12411247.

34. M Miller , Incidence and persistence of Staphylococcus aureus nasal colonization in a community sample of HIV-infected and -uninfected drug users. Clinical Infectious Diseases 2007; 45: 343346.

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Epidemiology & Infection
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