Pneumococcal Conjugate Vaccine Does Not Influence Staphylococcus aureus Carriage in Young Children with Acute Otitis Media

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Abstract
Several bacterial species that are common commensals of the nasopharynx are involved in respiratory tract or invasive infection [1]. It has been shown that some of these species are able to induce bacterial interference—the inhibition of one species by another [2]. One study reported an increased rate of Staphylococcus aureus culture–positive otorrhea in otitis-prone children aged 1–5 years who had received both 7-valent pneumococcal conjugate vaccine (PCV7) and a booster dose of pneumococcal polysaccharide vaccine [3]. Three subsequent studies suggested that, among patients who had not received PCV7, S. pneumoniae carriage (specifically for vaccine-type strains) is negatively associated with S. aureus carriage in children [4–6]. Moreover, the increasing prevalence of community-acquired methicillin-resistant S. aureus (MRSA) infection in some regions of the world is of concern [7]. In September 2001, when PCV7 was introduced in France, a national surveillance network of nasopharyngeal carriage of S. pneumoniae in children aged 6–24 months who had acute otitis media (AOM) was created to observe trends in S. pneumoniae serotypes and antibiotic resistance. The initial 3-year results of this surveillance were recently published elsewhere [8]. Since 2003, when the negative interaction between S. pneumoniae and S. aureus was suggested [3], surveillance was extended to S. aureus carriage, to investigate the possible association between both pathogens by studying their prevalence and risk factors for carriage in young children in an area where PCV7 immunization was progressively implemented [8].

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