Emerg Infect Dis. 2019 Nov;25(11):2040-2047. doi: 10.3201/eid2511.190157.
Increased nasopharyngeal pneumococcal (Streptococcus pneumoniae) colonization density has been associated with invasive pneumococcal disease, but factors that increase pneumococcal density are poorly understood. We evaluated pneumococcal densities in nasopharyngeal samples from asymptomatic young children from Peru and their association with subsequent acute respiratory illness (ARI). Total pneumococcal densities (encompassing all present serotypes) during asymptomatic periods were significantly higher when a respiratory virus was detected versus when no virus was detected (p<0.001). In adjusted analyses, increased pneumococcal density was significantly associated with the risk for a subsequent ARI (p<0.001), whereas asymptomatic viral detection alone was associated with lower risk for subsequent ARI. These findings suggest that interactions between viruses and pneumococci in the nasopharynx during asymptomatic periods might have a role in onset of subsequent ARI. The mechanisms for these interactions, along with other potentially associated host and environmental factors, and their role in ARI pathogenesis and pneumococcal transmission require further elucidation.
鼻咽部肺炎链球菌（肺炎链球菌）定植密度增加与侵袭性肺炎球菌病有关，但增加肺炎球菌密度的因素尚不清楚。我们评估了来自秘鲁无症状幼儿的鼻咽样本中的肺炎球菌密度及其与随后发生的急性呼吸道感染（ARI）的关系。与未检测到病毒时相比，无症状期间检测到呼吸道病毒时，总肺炎球菌密度（包括所有现有血清型）显著更高（p<0.001）。在调整后的分析中，肺炎球菌密度增加与随后发生 ARI 的风险显著相关（p<0.001），而无症状的病毒检测本身与随后发生 ARI 的风险较低相关。这些发现表明，无症状期间鼻咽部病毒和肺炎球菌之间的相互作用可能在随后发生 ARI 的发病机制中起作用。需要进一步阐明这些相互作用的机制，以及其他潜在相关的宿主和环境因素，以及它们在 ARI 发病机制和肺炎球菌传播中的作用。
