Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa.
Respiratory microbes present in the nasopharynx of children hospitalised with suspected pulmonary tuberculosis in Cape Town, South Africa.
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DOI：
10.1186/s12879-016-1934-z
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发表时间：
2016-10-24
影响因子：
3.7
通讯作者：
Nicol MP
中科院分区：
文献类型：
--
作者：
Dube FS;Kaba M;Robberts FJ;Ah Tow L;Lubbe S;Zar HJ;Nicol MP
儿童下呼吸道感染越来越多地被认为是多种微生物的起源。有肺结核（PTB）症状的儿童可能患有结核病、其他呼吸道感染或合并结核分枝杆菌和其他病原体感染。我们的目的是确定是否存在潜在的呼吸道病原体鼻咽（NP）样本与疑似PTB的儿童。从红十字儿童医院（南非开普敦）连续出现疑似PTB的儿童中收集的NP样本通过多重实时RT-PCR进行检测。对从每名受试者获得的2个诱导的分枝杆菌进行分枝杆菌液体培养和Xpert MTB/RIF。儿童被分类为明确的结核病（培养或qPCR [Xpert MTB/RIF]证实），不太可能的结核病（症状改善，随访时未接受结核病治疗）和未证实的结核病（所有其他儿童）。在214名中位年龄为36个月（四分位距，[IQR] 19-66个月）的儿童中，34名（16%）患有明确的TB，86名（40%）患有未确认的TB，94名（44%）被归类为不太可能的TB。卡他莫拉菌（64%）、肺炎链球菌（42%）、流感嗜血杆菌（29%）和金黄色葡萄球菌（22%）是NP样本中检测到的最常见细菌。其他检出的细菌包括肺炎支原体（9%）、百日咳杆菌（7%）和肺炎嗜衣原体（4%）。最常见的病毒包括偏肺病毒（19%）、鼻病毒（15%）、C型流感病毒（9%）、腺病毒（7%）、巨细胞病毒（7%）和冠状病毒O 43（5.6%）。在确诊、未确诊和不太可能患结核病的人群中，分别有73%、55%和56%检出细菌和病毒。肺结核患儿与非肺结核患儿的呼吸道微生物分布无显著差异。应用二次判别分析方法，对人偏肺病毒、C。肺炎，冠状病毒043，流感病毒C病毒，鼻病毒和巨细胞病毒最好的区分与其他组的儿童明确结核病的儿童。在疑似结核病儿童中检测到广泛的潜在呼吸道病原体。结核病分类与特定病原体的检测之间没有明确的联系。需要进一步的工作来探索潜在的病原体相互作用及其在PTB发病机制中的作用。本文的在线版本（doi：10.1186/s12879-016-1934-z）包含补充材料，可供授权用户使用。
Lower respiratory tract infection in children is increasingly thought to be polymicrobial in origin. Children with symptoms suggestive of pulmonary tuberculosis (PTB) may have tuberculosis, other respiratory tract infections or co-infection with Mycobacterium tuberculosis and other pathogens. We aimed to identify the presence of potential respiratory pathogens in nasopharyngeal (NP) samples from children with suspected PTB. NP samples collected from consecutive children presenting with suspected PTB at Red Cross Children’s Hospital (Cape Town, South Africa) were tested by multiplex real-time RT-PCR. Mycobacterial liquid culture and Xpert MTB/RIF was performed on 2 induced sputa obtained from each participant. Children were categorised as definite-TB (culture or qPCR [Xpert MTB/RIF] confirmed), unlikely-TB (improvement of symptoms without TB treatment on follow-up) and unconfirmed-TB (all other children). Amongst 214 children with a median age of 36 months (interquartile range, [IQR] 19–66 months), 34 (16 %) had definite-TB, 86 (40 %) had unconfirmed-TB and 94 (44 %) were classified as unlikely-TB. Moraxella catarrhalis (64 %), Streptococcus pneumoniae (42 %), Haemophilus influenzae spp (29 %) and Staphylococcus aureus (22 %) were the most common bacteria detected in NP samples. Other bacteria detected included Mycoplasma pneumoniae (9 %), Bordetella pertussis (7 %) and Chlamydophila pneumoniae (4 %). The most common viruses detected included metapneumovirus (19 %), rhinovirus (15 %), influenza virus C (9 %), adenovirus (7 %), cytomegalovirus (7 %) and coronavirus O43 (5.6 %). Both bacteria and viruses were detected in 73, 55 and 56 % of the definite, unconfirmed and unlikely-TB groups, respectively. There were no significant differences in the distribution of respiratory microbes between children with and without TB. Using quadratic discriminant analysis, human metapneumovirus, C. pneumoniae, coronavirus 043, influenza virus C virus, rhinovirus and cytomegalovirus best discriminated children with definite-TB from the other groups of children. A broad range of potential respiratory pathogens was detected in children with suspected TB. There was no clear association between TB categorisation and detection of a specific pathogen. Further work is needed to explore potential pathogen interactions and their role in the pathogenesis of PTB. The online version of this article (doi:10.1186/s12879-016-1934-z) contains supplementary material, which is available to authorized users.
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影响因子：
3.7
作者：
Kwambana BA;Barer MR;Bottomley C;Adegbola RA;Antonio M
通讯作者：
Antonio M
DOI：
10.1016/s2213-2600(16)00096-5
发表时间：
2016-06
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
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通讯作者：
Nicol MP
影响因子：
3.7
作者：
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通讯作者：
Madhi, Shabir A.
影响因子：
6.4
作者：
Roberts, Teri;Beyers, Nulda;Walzl, Gerhard
通讯作者：
Walzl, Gerhard
影响因子：
6.4
作者：
Graham, Stephen M.;Ahmed, Tahmeed;Wingfield, Claire
通讯作者：
Wingfield, Claire