Differences in nasopharyngeal bacterial carriage in preschool children from different socio-economic origins
Differences in nasopharyngeal bacterial carriage in preschool children from different socio-economic origins
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DOI：
10.1111/j.1469-0691.2010.03410.x
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发表时间：
2011-06-01
影响因子：
14.2
通讯作者：
Vergison, A.
中科院分区：
文献类型：
--
作者：
Jourdain, S.;Smeesters, P. R.;Vergison, A.
在2006-2008年期间，对比利时布鲁塞尔地区两种不同社会经济环境的学龄前健康儿童（3-6岁）进行了一项前瞻性队列研究。目的是评价在引入PCV 7疫苗时肺炎链球菌、金黄色葡萄球菌、卡他莫拉菌和流感嗜血杆菌在鼻咽的定植，并评估社会经济水平对植物群组成和抗生素耐药性的影响。共收集了333名儿童的830份鼻咽样本和流行病学资料。确定了肺炎球菌血清型和抗生素耐药性。通过多因素logistic回归分析携带和细菌相关性的危险因素。所有病原体的携带率都很高。50%的儿童至少有一次被S.金黄色葡萄球菌感染率为69%;肺炎支原体感染率为67%。卡他性鼻炎和H.流感。来自较高社会经济环境和S.肺炎链球菌血清型相应地变化。来自社会经济水平较低的学校的儿童更容易携带M。catarrhalis，卡他沙门氏菌S.金黄色葡萄球菌和耐药链球菌。肺炎，包括高比例的不可分型的肺炎球菌菌株。S之间的正相关。pneumoniae和H.流行性感冒，介于H.流感和M. catarrhalis和H.流感和S.金黄色葡萄球菌。我们的研究表明鼻咽部植物群组成不仅受年龄的影响，而且受社会经济环境的影响。儿童的鼻咽可能代表了一个独特的动态环境，由细菌种类，宿主免疫系统和PCV 7免疫之间复杂的相互作用调节。
A prospective cohort study of preschool healthy children (3-6 years old) from two distinct socio-economic settings in the Brussels area, Belgium, was conducted during the years 2006-2008. The objectives were to evaluate nasopharyngeal colonization by Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis and Haemophilus influenzae at the time of PCV7 vaccine introduction and to assess the socio-economic level impact on flora composition and antibiotic resistance. Three hundred and thirty-three children were included and a total of 830 nasopharyngeal samples were collected together with epidemiological data. Pneumococcal serotypes and antibiotic resistance profiles were determined. Risk factors for carriage and bacterial associations were analysed by multivariate logistic regression. Carriage rates were high for all pathogens. Fifty per cent of the children were colonized at least once with S. aureus, 69% with S. pneumoniae, 67% with M. catarrhalis and 83% with H. influenzae. PCV7 uptake was higher among children from a higher socioeconomic setting and S. pneumoniae serotypes varied accordingly. Children from lower socio-economic schools were more likely to carry M. catarrhalis, S. aureus and antibiotic-resistant S. pneumoniae, including a high proportion of non-typeable pneumococcal strains. Positive associations between S. pneumoniae and H. Influenza, between H. influenzae and M. catarrhalis and between H. influenzae and S. aureus were detected. Our study indicates that nasopharynx flora composition is influenced not only by age but also by socioeconomic settings. A child's nasopharynx might represent a unique dynamic environment modulated by intricate interactions between bacterial species, host immune system and PCV7 immunization.