Streptococcus vaccination and MRSA

Abstract

586 www.thelancet.com/infection Vol 12 August 2012 Several studies have shown that nasopharyngeal carriage of vaccine-type S pneumoniae strains is negatively associated with Staphylococcus aureus carriage in the nasopharynx. Selva and co-workers described an antistaphylococcal mechanism whereby S pneumoniae kills S aureus by producing hydrogen peroxide. van Gils and colleagues report that use of the vaccine increased carriage of S aureus in a cohort of Dutch children. Could use of polyvalent pneumococcal vaccines be driving the increased incidence of community-acquired meticillin-resistant S aureus (MRSA) infection? Although Miller and colleagues did describe S pneumoniae serotype replacement, they did not investigate S aureus carriage. To show a negative association between S pneumoniae and S aureus carriage in a UK cohort of heptavalent pneumococcal conjugate vaccine recipients would be useful. Further studies should explore the link between vaccination and staphylococcal disease, both in vaccine recipients and the people they contact. Meticillin-resistant and meticillin-sensitive strains should be distinguished in investigations of S aureus carriage. The Panton-Valentine leukocidin status of the isolate should also be investigated because it is linked epidemiologically with communityacquired MRSA infection. These data would help to clarify any role that pneumococcal vaccines might have in S aureus infection.