Pneumococcal Vaccination Might Reduce Antibiotic-Resistant Gut Bacteria in Kids
A Guatemalan study sheds light on how routine vaccines could influence gut bacteria that resist antibiotics.
In this cross-sectional, community-based investigation, researchers explored whether standard pneumococcal vaccination and rotavirus vaccination affect the carriage of extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) among children under 15 years old in Guatemala. Participants (406 children aged 0–14) provided questionnaire data, vaccination records, and stool samples. Stool specimens were cultured on selective media, and antibiotic susceptibility was verified with an automated system. The team used an instrumental variables approach with three nested probit models to map direct and indirect connections among vaccination status, healthcare utilization, diarrheal episodes, and ESCrE colonization.
Pneumococcal Vaccination and ESCrE Carriage
Receiving the pneumococcal vaccine (PCV13) was linked to a lower likelihood of ESCrE colonization. This protective effect seemed to operate indirectly by reducing the frequency of clinic visits. In the analytical models, PCV13 vaccination exerted an indirect shield against ESCrE carriage, whereas antibiotic use tended to increase clinic visits but did not show a clear direct or indirect influence on ESCrE colonization. Results for rotavirus vaccination were inconclusive, largely due to a small proportion of children who had not been vaccinated against rotavirus, which limited statistical power to detect an effect.
Beyond vaccination, multiple contextual and behavioral factors correlated with ESCrE colonization. Recent diarrheal illness raised the risk of colonization, possibly reflecting disruption of gut microbiota and heightened contact with healthcare services. Interestingly, yogurt consumption showed a modest protective association with ESCrE carriage in the models that included both pneumococcal and rotavirus vaccination. Conversely, households with land use for agriculture were associated with a higher probability of colonization, suggesting environmental reservoirs of antibiotic-resistant bacteria.
Overall, the study reinforces that antimicrobial resistance in Enterobacterales emerges from a complex mix of vaccination status, infection burden, care-seeking behavior, antimicrobial exposure, diet, and environmental influences. The authors caution that these findings should be validated in larger studies that also capture concrete clinical outcomes alongside colonization data.
Reference: Ramay B M et al. Assessing effects of pneumococcal vaccination (PCV13) and rotavirus vaccination (RV) on colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in Guatemalan children. Vaccine. 2025;66:127852.
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