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Master of Public Health

Association between nasopharyngeal colonization with multiple pneumococcal serotypes and total pneumococcal colonization density in young Peruvian children

AUTHORS

Howard LM , Huang X , Chen W , Liu Y , Edwards KM , Griffin MR , Zhu Y , Vidal JE , Klugman KP , Gil AI , Soper NR , Thomsen IP , Gould K , Hinds J , Lanata CF , Grijalva CG , . International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2023 7 12; ().

ABSTRACT

BACKGROUND: We examined the association of nasopharyngeal (NP) pneumococcal co-colonization (>1 pneumococcal serotype) and pneumococcal density in young Peruvian children enrolled in a prospective cohort study.

METHODS: NP swabs collected monthly from children <3 years of age during both asymptomatic and ARI periods underwent culture-enriched microarray for pneumococcal detection and serotyping and lytA PCR for density assessment. We examined serotypes commonly associated with co-colonization and the distribution of densities by co-colonization, age, current ARI, and other covariates. The association of co-colonization and pneumococcal density was assessed using a multivariable mixed effects linear regression model, accounting for repeated measures and relevant covariates.

RESULTS: Twenty-seven children contributed 575 monthly NP samples. Pneumococcus was detected in 302/575 (53%), and co-colonization was detected in 61 of these 302 (20%). Total densities were higher during ARI than non-ARI periods and lowest among the youngest children, increasing with age. In multivariable analysis, there was no significant association between pneumococcal density and co-colonization (coefficient estimate 0.22, 95% CI -0.11, 0.55; reference: single serotype detections). Serotypes 23B and 19F were detected significantly more frequently as single isolates.

CONCLUSIONS: Pneumococcal co-colonization was common and not associated with increased pneumococcal density. Differential propensity for co-colonization was observed among individual serotypes.

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