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Updated: Oct 18, 2025
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Nasopharyngeal Carriage in Children After the Introduction of Generalized Infant Pneumococcal Conjugate Vaccine
Markus A Rose1, Maren Laurenz2, Ralf Sprenger2
1Klinikum Stuttgart Olgahospital, Stuttgart, Germany.
Insights
Pneumococcal conjugate vaccine (PCV) immunization in German infants significantly reduced PCV serotypes in nasopharyngeal carriage. Non-PCV serotypes increased, highlighting the vaccine
Area of Science:
- Pediatric infectious diseases
- Bacteriology
- Immunization impact studies
Background:
- Nasopharyngeal (NP) bacterial carriage data in German children are limited.
- Understanding colonization patterns is crucial for evaluating immunization strategies.
Purpose of the Study:
- To prospectively characterize NP bacterial colonization in German infants.
- To evaluate the impact of pneumococcal conjugate vaccine (PCV) immunization on NP bacterial carriage.
Main Methods:
- Longitudinal NP swab collection from infants at multiple time points (2 months to 5 years).
- Bacterial culture, isolation, and serotyping of NP flora.
- Evaluation of demographic risk factors for colonization.
Main Results:
- Bacterial NP carriage increased with age, with *S. pneumoniae*, *H. influenzae*, *M. catarrhalis*, and *S. pyogenes* as leading isolates.
- Overall pneumococcal carriage rose significantly, especially in day-care attendees.
- PCV immunization led to near eradication of PCV serotypes, with a rise in non-PCV serotypes (e.g., 11A, 22F, 23A).
Conclusions:
- Universal infant PCV immunization in Germany effectively reduced vaccine-type pneumococcal serotypes in NP carriage.
- A shift towards non-vaccine pneumococcal serotypes was observed, indicating potential serotype replacement.
- The findings underscore the significant impact of PCV on the nasopharyngeal microbiome in young children.
Abstract:
Epidemiological data on nasopharyngeal (NP) bacterial carriage in children in Germany are scarce. We prospectively characterized NP colonization to evaluate the impact of pneumococcal immunization. We longitudinally collected NP swabs from 2-month-old infants (visit 1; V1) at eight representative pediatric offices 10/2008-06/2009. The second swabs were taken at age 9-12 months (V2); the third swab was taken 3-6 months after the booster vaccination at age 17-19 months (V3), and the fourth swab (V4) at age 59-61 months. Samples were broth enriched, cultured for bacteria, and isolates were serotyped. Demographic risk factors for colonization were evaluated. Among 242 vaccinees, bacterial NP carriage increased with age [from 27.2% (V1) to 70.1% (V4)]; leading isolates were S. pneumoniae, H. influenzae, M. catarrhalis, and S. pyogenes. Overall pneumococcal carriage increased [14.7% (V1), 31.5% (V2), 34.8% (V3), 42.2% (V4)], being even greater among day-care attendees. Serotype distribution changed during the study period, with vaccine serotypes declining. At visit 4, 10-valent pneumococcal conjugate vaccine (PCV10) serotypes were no longer among the NP flora, while some serotypes unique to 13-valent pneumococcal conjugate vaccine (PCV13; 3 and 19A) were found. In Germany, universal infant PCV immunization was associated with an almost complete eradication of PCV-serotypes and concomitant increase of non-PCV-serotypes, mainly 11A, 22F, and 23A.
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