Upper respiratory colonization by Streptococcus pneumoniae in healthy pre-school children in south-east Poland
Upper respiratory colonization by Streptococcus pneumoniae in healthy pre-school children in south-east Poland
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DOI：
10.1016/j.ijporl.2011.08.021
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发表时间：
2011-12-01
影响因子：
1.5
通讯作者：
Malm, Anna
中科院分区：
文献类型：
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作者：
Korona-Glowniak, Izabela;Niedzielski, Artur;Malm, Anna
目的：肺炎链球菌在健康儿童上呼吸道的携带是肺炎链球菌株水平传播的主要因素，尤其是在托儿所的儿童之间，也可能是其他个体的感染源。在为期8个月的3个季节(秋季、冬季、春季)的前瞻性研究中，我们确定了肺炎链球菌在健康学龄前儿童中一般定植和2~3个时间点定植的危险因素，包括青霉素不敏感的多重耐药菌株。最终，共鉴定出342株菌株。结果：72.4%的儿童至少被肺炎球菌定植1次，其中8.4%的儿童在3个时间点定植，25.4%的儿童定植2次，38.6%的儿童仅定植1次。36.3%的儿童至少有一次青霉素不敏感肺炎球菌定植，34.1%的儿童有多重耐药肺炎球菌定植。分别有10.9%和10.6%的儿童在2~3个时间点被青霉素不敏感和多重耐药菌株定植。肺炎球菌定植(一般或对青霉素不敏感的菌株)与日托、无兄弟姐妹、频繁的呼吸道感染和较多的抗生素疗程独立相关。在日托中心就诊的儿童，呼吸道感染频繁，暴露在烟草烟雾中，容易被多重耐药菌株定植。肺炎球菌包括青霉素不敏感菌株在2-3个时间点的定植风险与年龄和日托次数有关，而耐多药肺炎球菌定植在3岁儿童中显著高于3岁儿童，且呼吸道感染频繁且抗生素疗程较多。结论：这些结果表明波兰健康学龄前儿童上呼吸道肺炎链球菌定殖率很高，包括青霉素不敏感和多重耐药肺炎球菌的定植。(C)2011爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: Carriage of Streptococcus pneumoniae in upper respiratory tract of healthy children is a major factor in the horizontal transmission of pneumococcal strains, especially between children attending day-care centers and may be also the source of infection in other individuals. During 8-month prospective study including 3 seasons (autumn, winter, spring), we determined risk factors for S. pneumoniae colonization in general and colonization at 2 or 3 time points in healthy pre-school children, including penicillin non-susceptible likewise multidrug resistant strains.Methods: Pneumococcal cultures were obtained from 311 children aged 3-5. Finally, a total of 342 isolates were identified. Resistance of pneumococcal isolates was determined and information about potential risk factors were obtained from questionnaires.Results: A total of 72.4% children were colonized by pneumococci at least once, including 8.4% children colonized at 3 time points, 25.4% children - twice and 38.6% children - only once. Penicillin non-susceptible pneumococcal colonization was found in 36.3% children at least once while multidrug-resistant pneumococcal colonization in 34.1% children. Of the 10.9% and 10.6% children were colonized at 2 or 3 time points by penicillin non-sussceptible and multidrug-resistant isolates, respectively. Pneumococcal colonization (in general or by non-susceptible to penicillin isolates) was independently associated with day care attendance, having no siblings, frequent respiratory tract infections and higher number of antibiotic courses. Children attending day care center, with frequent respiratory tract infections, exposed to tobacco smoke were prone to colonization by multidrug-resistant isolates. Risk of colonization at 2 or 3 time points by pneumococcal isolates, including penicillin-nonsusceptible isolates, was associated with age and day care attendance while multidrug-resistant pneumococcal colonization was found to be significantly higher in children aged 3, with frequent respiratory tract infections and higher number of antibiotic courses.Conclusion: These results indicate high rate of upper respiratory colonization by S. pneumoniae in healthy preschool children in Poland, including colonization by penicillin non-susceptible and multidrug-resistant pneumococci. (C) 2011 Elsevier Ireland Ltd. All rights reserved.