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      Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children.

      Lancet
      Acute Disease, Adolescent, Adult, Carrier State, microbiology, Child, Child Day Care Centers, Child, Preschool, Female, Humans, Infant, Male, Nasopharynx, Pneumococcal Infections, Pneumococcal Vaccines, Recurrence, Reference Values, Serotyping, Staphylococcus aureus, isolation & purification, Streptococcus pneumoniae, classification

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          Abstract

          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.

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