TY - JOUR AU - Howard, Leigh AU - Zhu, Yuwei AU - Griffin, Marie AU - Edwards, Kathryn AU - Williams, John AU - Gil, Ana AU - Vidal, Jorge AU - Klugman, Keith AU - Lanata, Claudio AU - Grijalva, Carlos T1 - Nasopharyngeal Pneumococcal Density during Asymptomatic Respiratory Virus Infection and Risk for Subsequent Acute Respiratory Illness T2 - Emerging Infectious Disease journal PY - 2019 VL - 25 IS - 11 SP - 2040 SN - 1080-6059 AB - 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. KW - pneumococcus KW - pneumococcal colonization density KW - viral infection KW - acute respiratory illness KW - viruses KW - vaccine-preventable diseases KW - Peru KW - United States KW - children KW - respiratory infections KW - Streptococcus pneumoniae DO - 10.3201/eid2511.190157 UR - https://wwwnc.cdc.gov/eid/article/25/11/19-0157_article ER - End of Reference