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Updated: Jul 11, 2026

Experimental Human Pneumococcal Carriage
07:47

Experimental Human Pneumococcal Carriage

Published on: February 15, 2013

Association between carriage of Streptococcus pneumoniae and Staphylococcus aureus in Children

Gili Regev-Yochay1, Ron Dagan, Meir Raz

  • 1Sheba Medical Center, Tel Hashomer, Israel. gili.regev@sheba.health.gov.il

JAMA
|August 12, 2004
PubMed

Insights

Streptococcus pneumoniae carriage is inversely linked to Staphylococcus aureus carriage in children. This interaction is important for understanding respiratory tract flora changes, especially with pneumococcal conjugate vaccination.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Epidemiology

Background:

  • Pneumococcal conjugate vaccination may alter upper respiratory tract flora in children.
  • Emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) highlights potential interactions with Streptococcus pneumoniae.

Purpose of the Study:

  • To determine the prevalence and risk factors for Streptococcus pneumoniae and Staphylococcus aureus carriage in young children before widespread vaccination.
  • To investigate the relationship between carriage of these two common respiratory pathogens.

Main Methods:

  • Cross-sectional surveillance study conducted in primary care clinics in central Israel.
  • Nasopharyngeal and nasal swabs collected from 790 children aged 40 months or younger.
  • Analysis of carriage rates, serotypes for S. pneumoniae, and associated risk factors for both pathogens.

Main Results:

  • Prevalence: 43% carried S. pneumoniae, 10% carried S. aureus.
  • Inverse Association: S. pneumoniae carriage was lower in S. aureus carriers (27.5% vs 44.8%). S. aureus carriage was lower in S. pneumoniae carriers (6.5% vs 12.9%).
  • Dual Carriage: Only 2.8% carried both pathogens, which was less than the expected 4.3% (P=.03). Risk factors for S. pneumoniae carriage were negatively associated with S. aureus carriage.

Conclusions:

  • Streptococcus pneumoniae carriage, particularly vaccine-type strains, is negatively associated with Staphylococcus aureus carriage in children.
  • These findings suggest a complex interaction between these pathogens that warrants further investigation in the context of pneumococcal vaccination programs.
Abstract

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