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.
【저자키워드】 Haemophilus influenzae, Staphylococcus aureus, colonization, pneumococcus, pneumococcal conjugate vaccine, Bacterial interaction,