Many factors have been identified to promote the clonal spread of multiresistant strains; such as places with high density of children as in DCC and orphanages. S. pneumonia, that are resistant to many antimicrobial agents. Extensive and often excessive use of antibiotics can promote the replacement of strains susceptible to antimicrobial agents by resistant ones (Garcia-Rodriguez and Fresnadillo Martinez 2002), (Pradier, Dunais et al. 1997). Despite adequate antibiotic treatment, morbidity and mortality due to pneumococcal disease remain high (Butler, Shapiro et al. 1999). Moreover, the increase of multidrug resistance among pneumococcal isolates hampers adequate treatment (Crook and Spratt 1998), (Klugman 1996), (Tomasz 1997). These strains are subsequently disseminated in the community by other contacts of colonized children, e.g., their siblings and parents. It is possible to limit the spread of some serotypes of S. pneumoniae by vaccination, but studies of the impact of immunization on colonization have yielded discrepant results (Dagan, Givon-Lavi et al. 2002), (Dagan, Melamed et al. 1996), (Dagan, Muallem et al. 1997), (Mbelle, Huebner et al. 1999). New pneumococcal conjugate vaccines have been shown to be effective against invasive diseases in young children (Black, Shinefield et al. 2000). Furthermore, a protective effect against respiratory tract infections such as (recurrent) otitis media has been observed (Black, Shinefield et al. 2000), (Eskola, Kilpi et al. 2001). Thus far, the 7-valent pneumococcal conjugate vaccine Prevenar (Wyeth) has been approved by the U.S. Food and Drug Administration and the European Committee on Proprietary Medicinal Products and is recommended by the U.S. Advisory Committee on Immunization Practices for the prevention of invasive diseases in children under 2 years of age. Recommendations are also made for older children at increased risk for invasive disease, such as those with human immunodeficiency virus infection and asplenia and those with increased risk for pneumococcal mucosal disease, such as children with recurrent acute otitis media. The effect of the 7-valent pneumococcal conjugate vaccine followed by a 23-valent polysaccharide vaccine in children aged 1 to 7 years with a history of recurrent acute otitis media was studied (Veenhoven, Bogaert et al. 2003). Clinically, no protective effect of the pneumococcal vaccines on recurrence of acute otitis media was found. At the nasopharyngeal level, however, a significant reduction of colonization with vaccine-type pneumococci was found after vaccination, whereas a simultaneous increase in colonization with non vaccine serotypes was observed (Veenhoven, Bogaert et al. 2003), (van der Linden, Al-Lahham et al. 2007). The spread of non-vaccine 19A penicillin resistant pneumococcal strains in the USA is a very serious development indeed, the children had to be treated with levofloxacin and one became partially deaf. With widespread of Prevenar use in Jordan this clone might appear (Pichichero and Casey 2007; Pichichero and Casey 2007). Recently, a Ph D study in Jordan showed that the resistance of penicillin G to S. pneumoniae isolated from healthy children in the kindergarten has reached to 92%. The efficacy of the 7v PCV to define the disease burden in the developing countries has been studied .