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Over the sequential samples, 83% of the children were colonized at least once with H.?influenzae, 69% with S.?pneumoniae, 67% with M.?catarrhalis and 50% with S.?aureus (data not shown). The distribution of S.?pneumoniae, H.?influenzae, S.?aureus and M.?catarrhalis within samples and their associations are presented in Table?1. On the one hand, H.?influenzae was the most prevalent bacterial species (prevalence in the samples 60.9%), followed by S.?pneumoniae and M.?catarrhalis (42.5% and 41.9%, respectively) and S.?aureus (35.5%) (Table?1a). On the other hand, isolation of S.?pneumoniae with H.?influenzae alone or together with M.?catarrhalis, forming the classical otitis media (OMA) triad, was very common (10 and 11% of the samples, respectively) (Table?1a). Fifteen per R428 cent of the samples did not contain any E-64 of the four studied species and were mostly nasal (p?0.001) (data not shown). Positive associations were significantly found for H.?influenzae with the three other pathogens (S.?pneumoniae, M.?catarrhalis or S.?aureus) (Table?1b). Young age (under 4?years old) was a risk factor for M.?catarrhalis carriage while S.?aureus was more likely to be isolated in older children (Table?2). PD school attendees were more likely to carry M.?catarrhalis and S.?aureus than HL school attendees. No differences in S.?pneumoniae and H.?influenzae carriage between the two populations were observed. Presence of other children in the house was negatively associated with M.?catarrhalis carriage and positively with S.?pneumoniae carriage. Smokers in the home were not a major risk factor as only M.?catarrhalis was more frequently isolated from children with smoking parents. By contrast, attending a DCC prior to preschool decreased the risk of carrying M.?catarrhalis. PCV7 immunization had no effect on see more the carriage rate of these four main pathogens. Thirty-one serotypes were identified among 362 S.?pneumoniae isolates (nine samples showed two different serotypes) (Table?3). The five most prevalent serogroups/types were 6B, 19F, 23F, 6A and non-typeable pneumococci (NTP). VT isolates were significantly more commonly recovered from children attending PD than HL schools (35% vs. 23%, p?