Site-Specific Disease Potential of Individual Streptococcus pneumoniae Serotypes in Pediatric Invasive Disease, Acute Otitis Media and Acute Conjunctivitis

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Abstract
Background: Recent studies have shown that some Streptococcus pneumoniae serotypes possess a higher potential to cause invasive disease than others. However, it is unknown whether disease potential for specific serotypes is similar for mucosal disease. Our objective was to assess the disease potential of individual S. pneumoniae serotypes causing invasive pneumococcal disease (IPD), acute otitis media (AOM) and acute conjunctivitis (AC) in children. Methods: Serotypes of pneumococcal isolates from children with IPD, AOM and AC were compared with those carried by healthy children aged S. pneumoniae. A significant negative association with IPD was demonstrated for nontypeable S. pneumoniae and with AOM for serotypes 6A, 6B, 15A and nontypeable S. pneumoniae. Conclusions: Our results reflect the importance of the polysaccharide capsule in site-specific disease potential and provide useful information regarding disease potential of nonvaccine serotypes shown to be involved in carriage replacement after vaccination with the 7-valent conjugate vaccine.