107, %, P < 01001

Transcription

1 Chin J Pediatr January 2002 Vol 40 No (PCR) (MP) ;307 ;81 (NPS) (RSV) (ADV) % ; % P < A ( GAS) 1816 % 615 % 213 % 210 % 210 % ;34 GAS % P < % % ;136 RSV % P < A ; ; ; ; ; Nasopharyngeal carriage status of common pathogenic microorganisms in healthy children and its clinical significance HOU Ancun LIU Yuhua XIN Deli et al. Department of Pediatrics Bejing Friendship Hospital Capital University of Medicine Sciences Beijing China Abstract Objective To understand carriage status of common pathogenic microorganisms in nasopharynx of healthy children and to explore the values of microbiological examinations on nasopharyngeal secretions in etiologic diagnosis of childhood respiratory tract infections.methods Totally healthy children from kindergartens and primary schools in the city and suburban areas of Beijing were enrolled in this study. The age of the children ranged from 0 to 13 years. Pharyngeal swabs and aspirated nasopharyngeal secretions (NPS) were collected from each subject. Mycoplasma pneumoniae (Mp) specific DNA was detected by using polymerase chain reaction (PCR) in of the specimens during the period from June 1995 to December 1996 ; bacterial culture was performed for 307 specimens collected from November 1998 to January 1999 ; viral isolation for respiratory syncytial virus (RSV) and adenovirus (AdV) was done for NPS from 81 children between November 1999 and April At the same time corresponding examinations were also performed for patients with acute respiratory infections. Results Carriage of Mp was found in 28/ subjects (1. 47 %) but the positive rate was % in acute lower respiratory tract infection patients (107/ 544 P < ). The positive rates of Streptococcus pneumonia ( S. pneumoniae) Hemophilus influenzae ( H. influenzae) Staphylococcus aureus ( S. aureus) Staphylococcus epidermidis ( S. epidermidis) and Group A streptococcus ( GAS) were % 6. 5 % 213 % 2. 0 % 2. 0 % respectively. However in 186 cases chosen at random for bacterial culture lower positive rates for bacterial pathogens were found although there was a higher positive rate in acute tonsillitis (76 %) for GAS compared with that in healthy children ( P < ). In none of the specimens was Neisseria meningitidis (N. meningitidis) found. In 81 healthy children under 3 years of age the positive rates of RSV and AdV were 4 % and 1 % respectively. But in 136 patients the positive rate of RSV was % ; so there was statistically significant difference for RSV between the two groups ( P < ). However only 5 patients were positive for AdV and there was no significant difference between the healthy children and the cases with acute respiratory infection. Conclusions the carriage rates of MP AdV RSV GAS and N. meningitidis in NPS in healthy : ( ) ( ) ( )

2 Chin J Pediatr January 2002 Vol 40 No. 1 children were very low. Therefore the positive findings for these pathogenic agents in NPS and pharyngeal swab probably have a high diagnostic value. However having a higher carriage rate of S. pneumoniae and H. influenzae in upper respiratory tract in healthy children the positive findings for these pathogens in pharyngeal swab have little clinical value. It is necessary to consider the laboratory findings together with clinical manifestations for making diagnosis. Additionally the carriage rates were related to age. Key words Nasopharyn ; Polymerase chain reaction ; Child ; Mycoplasma pneumoniae ; Respiratory synytial vineses : (1) EAGLE : Grand ; (3) : ; (4) Hela %CO 2 (35 ) 1824 h 013 : (1) 1 ; ; (2) 1 ; (3) ( ) PCR ; ( 23 d ) PCR ) ( d :SPSS : ( 26 ) PCR % 3 2 ; PCR % (107/ 544) ( 2 = P < 01001) 21 : (1) 5 % ; (2) 5 % mg ; (3) % 1816 % Oxoid (615 %) ;A 31 (RSV) (ADV) Island N1Y USA ; (2) : 11 PCR 21 : h ; 31 : 4 ) PCR 2 % 186

3 Chin J Pediatr January 2002 Vol 40 No ; A % ( 2 = P < [2 ] ) (1 2) 1147 % ( %) () () MP GAS 10 % ( %) RSV [6 ] GAS ; A 81 RSV % [7 ] % ;1 ADV2 [8 ] % RSV (3715 %) ; 5 ADV (317 %) Principi [9 ] RSV ( 2 = P < 01001) 315 % ( P > 1119 % ;De Lencastre [10 ] ) 47 %72 % ;Liassine [11 ] PCR 28 PCR % McMillan [3 ] MP 1716 % 26 % [4 ] 25 % 30 % [5 ] ; 307 ( GAS) 2 % [2 ] 1997 Turner GAS 1 (016 %) 219 %3911 % A 613 % Glezen %Hokama [12 ] 1 % ;1993 Kai 113 [1 ] 33 PCR 1 MP

4 Chin J Pediatr January 2002 Vol 40 No. 1 ; (colonization) 1 RSV % 1816 % 615 % [8 13 ] ; McMillan [3 ] RSV ADV % ; 216 % (0519 %) 1 RSV ADV % 81 3 RSV (4 %) ;1 ADV (1 %) 136 A RSV 3715 % ; 102 RSV [ % ] Hsu [15 ] 61 ; 27 (4413 %) 52 [18 2 (318 %) ] [16 ] PCR DNA 7814 % 20 1 ADV RSV MP [16 ] GAS NPS [17 RSV ] [19 ] ; ADV % RSV GAS 5 %

5 Chin J Pediatr January 2002 Vol 40 No Kai M Kamiya H Yabe B et al. Rapid detection of Mycoplasma pneumoniae in clinical samples by the polymerase chain reaction. J Med Microbiol : Homoe P Prag J Olsen CB et al. Nasopharyngeal bacteria found on blood agar plats from healthy children in Greenland. Int J Circumpolar Health : McMillan JA Sandstrom C Weiner LB et al. Viral and bacterial organisms associated with acute pharyngitis in a school2aged population. J Pediatr : Mar CD. Managing sore throat : a literature review. Med J Aust : Turner JC Hayden FG Lobor MC et al. Epidemiologic evidence for lancefield group C beta2hemolitic streptococci as a cause of exudative pharyngitis in college students. J Clin Microbiol : : : Principi N Marchisio P Schito GC et al. Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. Pediatr Infect Dis J : De Lencastre H Kristinsson KG Brito Avo A et al. Carriage of : respiratory tract pathogens and molecular epidemiology of Streptococcus pneumonia colonization in healthy children attending day care centers in Lisbon Portugal. Microb Drug Resist : Liassine N Gervaix A Hegi R et al. Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy children. Eur J Clin Microbial Infect Dis : Hokama T Yara A Hirayama K et al. Isolation of respiratory bacterial pathogens from the throats of healthy infants fed by different methods. J Trop Pediatr : Lopez B Cima MD Vazquez F et al. Epidemiological study of Streptococcus pneumonia carriers in healthy primary2school children. Eur J Clin Microbiol Infect Dis : : Hsu HY Kao CL Huang LM et al. Viral etiology of intussusception in Taiwanese childhood. Pediatr Infect Dis J : Marin J Jeler K D Levstek V et al. Persistence of viruses in upper respiratory tract of children with asthma. J Infect : A : : : ( : ) ( : ) ( ) : : ( ) : ICU( :100034) : NICU PICU :