Association between carriage of Streptococcus pneumoniae and Staphylococcus aureus in children

Gili Regev-Yochay, Ron Dagan, Meir Raz, Yehuda Carmeli, Bracha Shainberg, Estela Derazne, Galia Rahav, Ethan Rubinstein

Research output: Contribution to journalArticlepeer-review

241 Scopus citations


Context: Widespread pneumococcal conjugate vaccination may bring about epidemiologic changes in upper respiratory tract flora of children. Of particular significance may be an interaction between Streptococcus pneumoniae and Staphylococcus aureus, in view of the recent emergence of community-acquired methicillin-resistant S aureus. Objective: To examine the prevalence and risk factors of carriage of S pneumoniae and S aureus in the prevaccination era in young children. Design, Setting, and Patients: Cross-sectional surveillance study of nasopharyngeal carriage of Spneumoniae and nasal carriage of S aureus by 790 children aged 40 months or younger seen at primary care clinics in central Israel during February 2002. Main Outcome Measures: Carriage rates of S pneumoniae (by serotype) and S aureus; risk factors associated with carriage of each pathogen. Results: Among 790 children screened, 43% carried S pneumoniae and 10% carried S aureus. Staphylococcus aureus carriage among Spneumoniae carriers was 6.5% vs 12.9% in S pneumoniae noncarriers. Streptococcus pneumoniae carriage among S aureus carriers was 27.5% vs 44.8% in S aureus noncarriers. Only 2.8% carried both pathogens concomitantly vs 4.3% expected dual carriage (P = .03). Risk factors for S pneumonias carriage (attending day care, having young siblings, and age older than 3 months) were negatively associated with S aureus carriage. Conclusions: Streptococcus pneumoniae carriage, specifically of vaccine-type strains, is negatively associated with S aureus carriage in children. The implications of these findings in the pneumococcal vaccine era require further investigation.

Original languageEnglish
Pages (from-to)716-720
Number of pages5
Issue number6
StatePublished - 11 Aug 2004
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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