Co-colonization by Streptococcus pneumoniae and Staphylococcus aureus in the throat during acute respiratory illnesses
Co-colonization by Streptococcus pneumoniae and Staphylococcus aureus in the throat during acute respiratory illnesses
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DOI：
10.1017/s0950268816001473
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发表时间：
2016-12-01
影响因子：
4.2
通讯作者：
Foxman, B.
中科院分区：
文献类型：
--
作者：
De Lastours, V.;Malosh, R.;Foxman, B.
肺炎链球菌（Sp）或金黄色葡萄球菌（Sa）引起的肺炎是仅次于流感和急性呼吸道疾病（ARI）的大多数死亡原因。由于携带先于感染，我们估计Sp和Sa携带，以检查Sp、Sa和呼吸道病毒在口咽部存在ARI时的共定植动力学。我们用实时荧光定量PCR检测了社区（52岁）急性呼吸道感染患者的口咽标本是否存在甲型流感和乙型流感，以及其他11种常见呼吸道病毒Sp和Sa。共有338名参与者报告了519次ARI发作，其中119人（35%）携带Sp， 52人（13%）携带Sa， 25人（7%）两者都携带。35名受试者流感检测呈阳性，其中14人（40%）携带Sp， 6人（17%）携带Sa，显著高于流感阴性组（P=0.03和P=0.04）。在感染任何病毒的受试者中，与未感染病毒的受试者相比，携带Sp（39.2%对27.9%,P = 0.03）比携带Sa（11.6%对14%，P = 0.6）更常见。对于儿童，当Sa存在时，考虑到病毒感染的存在，Sp携带的频率往往比预期的要低，但并不显著[观察到的相对风险为1.14,95%置信区间（CI） 0.4-3.1；由于相互作用的相对超额风险为- 0.11]。与年龄无关，Sp携带者更有可能在那个季节再次出现ARI（优势比2.14,95% CI 1.1-4.3, P = 0.03）。在儿童流感感染期间，口咽部的Sp和Sa携带率均增加。Sp和Sa之间没有负相互作用。Sp携带者比非携带者更有可能遭受随后的ARI发作。
Pneumonia due to either Streptococcus pneumoniae (Sp) or Staphylococcus aureus (Sa) accounts for most mortality after influenza and acute respiratory illness (ARI). Because carriage precedes infection, we estimated Sp and Sa carriage to examine the co-colonization dynamics between Sp, Sa and respiratory viruses in the presence of ARI in the oropharynx. We tested oropharyngeal specimens of community subjects (aged 52 years) with ARI for the presence of influenza A and B, 11 other common respiratory viruses, Sp and Sa, using real-time PCR. A total of 338 participants reported 519 ARI episodes of which 119 (35%) carried Sp, 52 (13%) carried Sa and 25 (7%) carried both. Thirty-five subjects tested positive for influenza, of which 14 (40%) carried Sp and six (17%) carried Sa, significantly more than in the influenza-negative group (P=0.03 and P=0.04, respectively). In subjects infected by any virus compared to those with no virus, Sp carriage (39.2% vs. 27.9%, P = 0.03) but not Sa carriage (11.6% vs. 14%, P = 0.6) was more frequent. For children, when Sa was present, Sp carriage tended to be less frequent than expected given the presence of viral infection, but not significantly [observed relative risk 1.14, 95% confidence interval (CI) 0.4-3.1; with a relative excess risk due to interaction of- 0.11]. Independent of age, Sp carriers were more likely to return that season with subsequent ARI (odds ratio 2.14, 95% CI 1.1-4.3, P = 0.03). Both Sp and Sa carriage rates in the oropharynx increase during influenza infection in children. However, no negative interaction between Sp and Sa was observed. Sp carriers are more likely to suffer subsequent ARI episodes than non-carriers.