The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis.
The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis.
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在幼儿进行上呼吸道和下呼吸道感染的细菌之间的关联：系统评价和荟萃分析。
DOI：
10.1016/j.cmi.2021.05.034
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Nicol MP
中科院分区：
文献类型：
--
作者：
Claassen-Weitz S;Lim KYL;Mullally C;Zar HJ;Nicol MP
小儿上呼吸道细菌定植在下呼吸道感染的发病机制中起着重要作用。系统地回顾了关于幼儿上呼吸道细菌定植与下呼吸道感染之间关系的文献。MEDLINE、Academic Search Premier、Africa-Wide Information和CINAHL、Scopus和Web of Science。1923年至2020年间发表的研究，调查了LRTI病例和对照组的URT细菌。5岁以下儿童有和没有急性LRTI。三名评审员独立筛选标题、摘要和全文。使用Mantel-Haenszel固定或随机效应模型进行荟萃分析。大多数合格的研究（41/50）在研究URT细菌时检测了鼻咽标本。大多数研究为横断面设计（44/50）。在中低收入国家（LMIC）的儿童中进行了24项研究。流感嗜血杆菌（合并OR 1.60; 95% CI 1.23-2.07）和克雷伯菌属的患病率较高。（合并OR 2.04; 95% CI 1.17-3.55）。在排除病例组与对照组在采样前接受更多抗生素治疗的研究后，我们观察到URT标本中肺炎链球菌的检出与LRTI之间呈正相关（合并OR 1.41; 95% CI 1.04-1.90）。肺炎链球菌高密度定植（>6.9 log 10拷贝/mL）与LRTI风险增加相关。链球菌和嗜血杆菌URT检测与LRTI之间的关联在属水平上得到16 S rRNA测序的支持。卡他莫拉菌和金黄色葡萄球菌的作用证据尚不确定。流感嗜血杆菌或克雷伯菌属的检测在URT中，与LRTI相关，而与肺炎链球菌相关的证据不太确定。需要进行评估URT微生物群落以及环境和宿主因素的纵向研究，以更好地了解儿童LRTI的发病机制。
Bacteria colonizing the upper respiratory tract (URT) of young children play a key role in the pathogenesis of lower respiratory tract infection (LRTI). To systematically review the literature on the association between bacteria colonizing the URT and LRTI among young children. MEDLINE, Academic Search Premier, Africa-Wide Information and CINAHL, Scopus and Web of Science. Studies published between 1923 and 2020, investigating URT bacteria from LRTI cases and controls. Children under 5 years with and without acute LRTI. Three reviewers independently screened titles, abstracts and full texts. Meta-analysis was done using Mantel–Haenszel fixed- or random-effects models. Most eligible studies (41/50) tested nasopharyngeal specimens when investigating URT bacteria. Most studies were of cross-sectional design (44/50). Twenty-four studies were performed in children in lower- or lower-middle-income countries (LMICs). There was higher prevalence of Haemophilus influenzae (pooled OR 1.60; 95% CI 1.23–2.07) and Klebsiella spp. (pooled OR 2.04; 95% CI 1.17–3.55) from URT specimens of cases versus controls. We observed a positive association between the detection of Streptococcus pneumoniae from URT specimens and LRTI after excluding studies where there was more antibiotic treatment prior to sampling in cases vs. controls (pooled OR 1.41; 95% CI 1.04–1.90). High density colonization with S. pneumoniae (>6.9 log10 copies/mL) was associated with an increased risk for LRTI. The associations between both Streptococcus and Haemophilus URT detection and LRTI were supported, at genus level, by 16S rRNA sequencing. Evidence for the role of Moraxella catarrhalis and Staphylococcus aureus was inconclusive. Detection of H. influenzae or Klebsiella spp. in the URT was associated with LRTI, while evidence for association with S. pneumoniae was less conclusive. Longitudinal studies assessing URT microbial communities, together with environmental and host factors are needed to better understand pathogenesis of childhood LRTI.
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DOI：
10.1016/s0140-6736(18)32203-7
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Causes of Death Collaborators
通讯作者：
GBD 2017 Causes of Death Collaborators
影响因子：
8.3
作者：
Dickson, Robert P.;Erb-Downward, John R.;Curtis, Jeffrey L.
通讯作者：
Curtis, Jeffrey L.
鼻咽抽吸物对小儿下呼吸道感染的诊断价值
影响因子：
6.1
作者：
Lu AZ;Shi P;Wang LB;Qian LL;Zhang XB
通讯作者：
Zhang XB
影响因子：
18.2
作者：
Dickson RP;Erb-Downward JR;Martinez FJ;Huffnagle GB
通讯作者：
Huffnagle GB
影响因子：
3.7
作者：
Bogaert D;Keijser B;Huse S;Rossen J;Veenhoven R;van Gils E;Bruin J;Montijn R;Bonten M;Sanders E
通讯作者：
Sanders E