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Published on: February 23, 2014
Nasopharyngeal microbial interactions in the era of pneumococcal conjugate vaccination
Eileen M Dunne1, Heidi C Smith-Vaughan, Roy M Robins-Browne
1Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. eileen.dunne@mcri.edu.au
Insights
Pneumococcal vaccination does not significantly impact Staphylococcus aureus carriage in children. However, it is linked to increased non-typeable Haemophilus influenzae in acute otitis media cases.
Area of Science:
- Microbiology
- Immunology
- Pediatrics
Background:
- The nasopharynx is a common site for microbial colonization in children, with Streptococcus pneumoniae being a key pathogen.
- Interactions between bacteria and viruses in the nasopharynx can influence colonization dynamics.
- Pneumococcal conjugate vaccination (PCV) has been observed to alter nasopharyngeal microbial communities, leading to the rise of non-vaccine serotypes.
Purpose of the Study:
- To review data on pathogen co-colonization in the nasopharynx, specifically focusing on Streptococcus pneumoniae.
- To assess the impact of pneumococcal vaccination on Staphylococcus aureus carriage and related diseases.
- To examine vaccine-induced changes in nasopharyngeal microbiology, including the role of non-typeable Haemophilus influenzae.
Main Methods:
- Literature review of studies investigating nasopharyngeal co-colonization.
- Analysis of data on Streptococcus pneumoniae and Staphylococcus aureus carriage.
- Examination of the effects of pneumococcal vaccination on microbial dynamics.
Main Results:
- Pneumococcal vaccination has not demonstrated a sustained impact on Staphylococcus aureus carriage.
- An association exists between pneumococcal vaccination and an increase in non-typeable Haemophilus influenzae in acute otitis media.
- Advances in detection methods are improving the study of nasopharyngeal microbiology.
Conclusions:
- Current evidence does not support a significant sustained increase in Staphylococcus aureus carriage due to pneumococcal vaccination.
- Pneumococcal vaccination is associated with shifts in nasopharyngeal microbial populations, impacting other pathogens.
- Further research, including baseline studies before vaccine introduction, is crucial for understanding vaccine-induced changes in nasopharyngeal microbiology.
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.
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