Shiri, Tinevimbo, Nunes, Marta C., Adrian, Peter V., Van Niekerk, Nadia, Klugman, Keith P. and Madhi, Shabir A. (2013) Interrelationship of Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus colonization within and between pneumococcal-vaccine naïve mother-child dyads. BMC Infectious Diseases, 13 . 483. ISSN 1471-2334.

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Abstract

Background:
A high prevalence of bacterial nasopharyngeal co-infections has been reported in children, however, such data is limited in adults. We examined the interaction of Haemophilus influenzae, Staphylococcus aureus and Streptococcus pneumoniae pharyngeal colonization in mother-child dyads.
Methods:
Pneumococcal-vaccine naïve children and their mothers had pharyngeal swabs undertaken at 1.6, 2.5, 3.5, 4.5, 7.4, 9.5, 12.5, 16.2 and 24.2 months of child’s age. Swabs were cultured for S. pneumoniae, H. influenzae and S. aureus using standard microbiologic methods. Multivariate generalized estimating equation-models were used to explore the associations of the three bacteria within and between children and their mothers.
Results:
In children, the observed probability of co-colonization was higher than expected. Well-defined associations in colonization between the bacteria were observed in children but not among mothers. In children, a synergistic association was observed between S. pneumoniae and H. influenzae (Adjusted odds ratio (AOR): 1.75, 95% CI: 1.32-2.32) and a negative association between S. pneumoniae and S. aureus (AOR: 0.51, 95% CI: 0.39-0.67) or H. influenzae and S. aureus (AOR: 0.24, 95% CI: 0.16-0.34) colonization. Additionally, all three bacteria had a higher likelihood of concurrent colonization. There was a strong association in colonization by the bacteria in children and their mothers, including increased likelihood of maternal colonization if the child was colonized by S. pneumoniae (AOR: 1.84, 95% CI: 1.28-2.63) and H. influenzae (AOR: 6.34, 95% CI: 2.24-18.0).
Conclusions:
The effects of immunization of children with pneumococcal-conjugate-vaccine in settings such as ours needs monitoring with regard to potential changes of pharyngeal bacterial ecology which could occur in vaccinated and –unvaccinated age-groups.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR355 Virology R Medicine > RB Pathology
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Pneumococcal vaccine, Pneumonia, Pneumococcal, Streptococcus pneumoniae -- Prevention, Vaccination -- South Africa, Haemophilus influenzae, Staphylococcus aureus, Staphylococcus aureus infections -- Pathogenesis
Journal or Publication Title:	BMC Infectious Diseases
Publisher:	BioMed Central Ltd.
ISSN:	1471-2334
Official Date:	December 2013
Dates:	Date Event December 2013 Published 17 October 2013 Available
Volume:	13
Article Number:	483
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	7 January 2016
Date of first compliant Open Access:	8 January 2016
Funder:	Bill & Melinda Gates Foundation, South African Research Chairs Initiative (SARChI), National Research Foundation (NRF)
Grant number:	OPP37875

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