Prevalence and associated factors of pneumococcal carriage among children with respiratory viral infections in Türkiye

Authors

  • Saliha Kanık-Yüksek Department of Pediatric Infectious Disease, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Selin Yıldız-Sametoğlu Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye https://orcid.org/0000-0001-9891-6655
  • Metehan Yaşar Tekin Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Sümeyye Aybike Servi-Genç Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Belgin Gülhan Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Tuğba Erat Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Hatice Kübra Konca Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Seval Özen Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Aysun Yahşi Pediatric Infectious Diseases Department, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Gülsüm İclal Bayhan Department of Pediatric Infectious Disease, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara Bilkent City Hospital, Ankara, Türkiye https://orcid.org/0000-0002-1423-4348
  • Sibel Aydoğan Department of Medical Microbiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Aslı Nur Özkaya-Parlakay Department of Pediatric Infectious Disease, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara Bilkent City Hospital, Ankara, Türkiye
  • Bedia Dinç Department of Medical Microbiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye

DOI:

https://doi.org/10.3855/jidc.22818

Keywords:

carriage, Streptococcus pneumoniae, respiratory, viruses, coinfection, pediatrics

Abstract

Introduction: The interaction between nasopharyngeal pneumococcal carriage (NPC) and respiratory viral infections (RVI) is poorly understood. This study aimed to investigate the prevalence and epidemiology of NPC, and its correlation with RVI.

Methodology: This retrospective study included patients aged < 18 years who presented with RVI symptoms between 1 February and 30 June 2023. Naso-oropharyngeal swabs were tested using quantitative polymerase chain reaction (PCR) for Streptococcus pneumoniae and respiratory viruses. Patients were grouped by NPC status and compared for viral detection, and clinical and demographic characteristics.

Results: NPC was detected in 15.7% (n = 1,185) of the 7,522 samples analyzed. The mean age was 56.5 ± 49.3 months, being significantly lower in NPC-positive patients (p < 0.001). Most (82%) were fully vaccinated against pneumococcus; 16% had underlying conditions. The most frequent viruses were adenovirus (17.2%), influenza B (9.0%), severe acute respiratory syndrome coronavirus 2 (5.3%), respiratory syncytial virus (4.9%), and influenza A (2.8%). Adenovirus (19.7%) and influenza B (11.0%) were significantly more frequent in NPC-positive patients than in NPC-negative patients (p < 0.001 for both). Overall, 20.5% were hospitalized, and 2.4% required intensive care. Intensive care admission was higher among NPC-positive patients, whereas mortality did not differ.

Conclusions: NPC was epidemiologically associated with the detection of certain respiratory viruses, particularly adenovirus and influenza B. Given the retrospective design and lack of pneumococcal serotype data, these findings should be interpreted as associations rather than evidence of causality. Further prospective studies are warranted to clarify the bacterial–viral interactions and their clinical relevance.

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Published

2026-07-31

How to Cite

1.
Kanık-Yüksek S, Yıldız-Sametoğlu S, Tekin MY, Servi-Genç SA, Gülhan B, Erat T, Konca HK, Özen S, Yahşi A, Bayhan G İclal, Aydoğan S, Özkaya-Parlakay AN, Dinç B (2026) Prevalence and associated factors of pneumococcal carriage among children with respiratory viral infections in Türkiye. J Infect Dev Ctries 20:1004–1012. doi: 10.3855/jidc.22818

Issue

Vol. 20 No. 07: July 2026

Section

Original Articles

License

Copyright (c) 2026 Saliha Kanık-Yüksek, Selin Yıldız, Metehan Yaşar Tekin, Sümeyye Aybike Servi-Genç, Belgin Gülhan, Tuğba Erat, Hatice Kübra Konca, Seval Özen, Aysun Yahşi, Gülsüm İclal Bayhan, Sibel Aydoğan, Aslı Nur Özkaya-Parlakay, Bedia Dinç

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