Epidemiological Markers for Interactions Among Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus

Joseph A Lewnard1, Noga Givon-Lavi2, Amit Huppert3

  • 1Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.

Insights

Polymicrobial carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in children suggests true interactions, not just confounding factors. Pneumococcal vaccination did not alter overall carriage of these key respiratory pathogens.

Area of Science:

  • Pediatric infectious diseases
  • Microbiome research
  • Vaccinology

Background:

  • Cocolonization of Streptococcus pneumoniae and Haemophilus influenzae is common in children.
  • An inverse relationship exists between Streptococcus pneumoniae/Haemophilus influenzae and Staphylococcus aureus colonization.
  • Understanding these interactions is crucial for predicting outcomes of clinical interventions like pneumococcal vaccination.

Purpose of the Study:

  • To investigate polymicrobial carriage patterns among children.
  • To determine if observed cocolonization patterns are due to true interspecies interactions or confounding factors.
  • To assess the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) on carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus.

Main Methods:

  • Longitudinal study of 769 children (369 Bedouin, 400 Jewish) in Israel.
  • Data collected from a 7-valent pneumococcal conjugate vaccine (PCV7) trial.
  • Children were swabbed 10 times between 2 and 30 months of age to analyze polymicrobial carriage.

Main Results:

  • Distinct age and seasonal distributions were observed for the pathogens.
  • Polymicrobial carriage associations remained significant after controlling for age and season.
  • PCV7 introduction led to pneumococcal serotype replacement but did not affect the overall carriage of Streptococcus pneumoniae, Haemophilus influenzae, or Staphylococcus aureus.

Conclusions:

  • The persistence of polymicrobial carriage patterns, independent of confounding factors, supports the existence of active interspecies interactions.
  • Pneumococcal serotype replacement following PCV7 may influence or prevent changes in Haemophilus influenzae and Staphylococcus aureus carriage.
Abstract

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