High Rate of Nasopharyngeal Carriage of Potential Pathogens Among Children in Greenland: Results of a Clinical Survey of Middle-Ear Disease

Homøe, Preben; Prag, Jørgen; Farholt, Stense; Henrichsen, Jørgen; Hornsleth, A; Kilian, Mogens; Jensen, Jørgen Skov

doi:10.1093/clinids/23.5.1081

Cited by 55 publications

(47 citation statements)

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“…It may cause various respiratory tract infections such as pharyngitis, croup, tracheobronchitis, and bronchiolitis besides pneumonia. Some data showed that the presence of M. pneumoniae in the upper respiratory tract was common in asymptomatic children, while others indicated that there was no evidence of asymptomatic carriage (6)(7)(8).…”

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Study of Two Separate Types of Macrolide-Resistant Mycoplasma pneumoniae Outbreaks

Wang

Yang

et al. 2016

Antimicrob Agents Chemother

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bTo study the complete natural process of a Mycoplasma pneumoniae outbreak in a semiclosed room such as a primary school room, we investigated two separate M. pneumoniae outbreaks involving 81 students in total in two primary schools in Hangzhou, China. M. pneumoniae isolates from pharyngeal swabs were detected by fluorescence quantitative real-time PCR (RT-PCR) and culture. The class in school M had 39 students, with 12 (30.8%) with positive M. pneumoniae detection results. The class from school J had 42 students, with 13 (31.0%) positive. The strains from two classes were confirmed to represent two clones (3/4/5/7/2 and 5/4/5/7/2) and to be macrolide resistant (A2063G) according to P1 and multilocus variable-number tandem-repeat analysis (MLVA) genotyping, determination of MIC of antibiotics, and sequencing. Students with M. pneumoniae isolates detected were divided into three groups: those carrying the isolates, those with upper respiratory tract infection (URI), and those with pneumonia. Longitudinal sampling performed using pharyngeal swabs showed that the persistence of M. pneumoniae was longest in the group of students with pneumonia. M. pneumoniae causes pneumonia outbreaks in schools, and the incidence of pneumonia has a higher rate than that of URI. The persistence of M. pneumoniae, with a median duration of 79.50 days in the group of students with pneumonia, differs from that of the infection state. Mycoplasma pneumoniae is one of the most common pathogens causing respiratory infection in both children and adults. It is an important pathogen that causes community-acquired pneumonia (CAP). About 4% to 20.8% of CAP cases in adults and 23% to 30% of cases in children are due to M. pneumoniae, especially in children older than 5 years of age, for whom the proportion is nearly 50% (1-5). It may cause various respiratory tract infections such as pharyngitis, croup, tracheobronchitis, and bronchiolitis besides pneumonia. Some data showed that the presence of M. pneumoniae in the upper respiratory tract was common in asymptomatic children, while others indicated that there was no evidence of asymptomatic carriage (6-8).M. pneumoniae causes numerous outbreaks in closed or semiclosed settings such as kindergartens, primary schools, middle schools, and universities (9-13). In China, M. pneumoniae infection is not a notifiable disease, so the prevalence of M. pneumoniae infection in schools is unclear. However, outbreaks of M. pneumoniae infections in semiclosed settings have been reported in recent years, and a resistant strain has emerged (12). In this study, we collaborated with the Center for Disease Control and Prevention (CDC) of Hangzhou, China, and investigated the prevalence of M. pneumoniae infection in two classes in two primary schools in Hangzhou, China. Therefore, this study helped us to get a better understanding of the complete natural process of M. pneumoniae outbreak and its results will contribute to prevention of M. pneumoniae infection in schools in the future. MATERIALS AND METHODSEthics sta...

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confidence: 99%

Study of Two Separate Types of Macrolide-Resistant Mycoplasma pneumoniae Outbreaks

Wang

Yang

et al. 2016

Antimicrob Agents Chemother

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“…This supports the idea that Aborigine populations are colonised by variants of nasopharyngeal commensals with which they have not co-evolved, and to which they may not have the genetic repertoire to mount a directed and specific immune response. More frequent and more dense nasopharyngeal colonisation by otopathogens has also been documented in the Inuit (Homoe et al 1996b).…”

Section: Ethnic Variations In Otitis Media Incidencementioning

confidence: 88%

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

Bhutta¹

2015

Human Biology

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Inflammation of the middle ear (otitis media) comprises a group of disorders that are highly prevalent in childhood, and indeed are amongst the most common disorders of childhood. Otitis media is also heritable, and has effects on fecundity. This means that otitis media is subject to evolution, yet the evolutionary selection forces that may determine susceptibility to otitis media have never been adequately explored.Here I undertake a critical analysis of evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those determining function of the middle ear, those affecting host immunity, and those affecting colonization by, and pathogenicity of bacteria. I review existing mathematical evolutionary models of host-pathogen interaction and co-evolution, and apply these to develop a better understanding of the complex evolutionary landscape of middle ear infection and inflammation in humans. This includes an understanding of factors Pre--print version. Visit http://digitalcommons.wayne.edu/humbiol/ after 1 October 2015 to acquire the final version.2 determining the transition between stable evolutionary strategies for host and bacterial pathogens. This understanding will be later applied to analysis of otitis media in indigenous populations.In the second part of this article, I apply the approach of population genetics to devise a new theory for the high prevalence of otitis media in certain indigenous populations: the Australian Aborigine, the Native American, the Inuit, and the Maori.I suggest that high prevalence in such groups may have occurred as a result of colonization of these previously isolated populations by European immigrants in the 15 th and 16 th Centuries. This exposed them to new strains of bacteria to which their immune system had not evolved immunity, perturbing a previously stable hostpathogen co-evolutionary state.

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“…Persistent carriage was more frequent with these types. On the other hand, persistent nasopharyngeal carriage of single strains was serotype-dependent 6,14,19,23 and occurred more commonly between 5 and 8 months of age. The duration of carriage decreased with the carriage of successive pneumococcal serotypes and hence was inversely correlated with age.…”

Section: Discussionmentioning

confidence: 97%

“…Our findings supports earlier studies from similar centers over the last decade. [9][10][11][12][13][14][15][16][17][18][19][20][21] Recent research established daycare attendance as an important factor influencing the epidemiology of many infectious diseases. [26][27][28] A number of studies have demonstrated a strong association between daycare attendance and increased carriage of S. pneumoniae, especially of resistant strains.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16][17][18][19][20][21] Upper respiratory tract and invasive infections caused by such strains have increased. Antibiotic-resistant pneumococci were more common in isolates from children in DCC than in isolates from patients admitted at a tertiary care hospital -a group of patients presumably at increased risk of infection by resistant strains.…”

Section: Introductionmentioning

confidence: 99%

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Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

Gómez-Barreto¹,

Calderón-Jaimes²,

Rodrı́guez³

et al. 2002

Salud pública Méx

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ResumenObjetivo. Analizar longitudinalmente la dinámica de colonización por Streptococcus pneumoniae, determinar la prevalencia, los factores de riesgo potencial para la colonización nasofaríngea con cepas de neumococo resistentes, determinar los serotipos y el perfil de sensibilidad a varios fár-macos antimicrobianos. Material y métodos. Estudio prospectivo de una cohorte de niños de guardería, hecho de septiembre de 1997 a septiembre de 1999 entre 53 niños asistentes a la guardería del Hospital Infantil de México Federico Gómez, atendida por 20 empleados. Todos los participantes fueron seguidos en forma prospectiva, tomándose exudado nasofaríngeo cada cuatro meses. Los S. pneumoniae aislados se tipificaron y sometieron a pruebas de sensibilidad a diversos fármacos. Las razones de momios y la prueba exacta de Fisher o ji cuadrada se efectuaron a través de tablas de contingencia; se utilizaron intervalos de confianza a 95% para las razones de momios. Para el análisis se empleó el programa estadístico EPI INFO, versión 6.04 a. Resultados. S. pneumoniae se recuperó de 45/53 niños en una o más de las tomas. Se aisló un total de 178 cepas. El promedio de portador fue de 47%. Sólo siete adultos adquirieron un neumococo durante el estudio. Los tipos 6, 14, 19 y 23 representaron 77% del total. Se encontró elevada resistencia a la penicilina y eritromicina. Conclusiones. El estado de portador nasofaríngeo de S. pneumoniae, es un proceso dinámico. La colonización ocurre durante los primeros meses de vida y comprende solamente unos cuantos serotipos de neumococo. El estado portador disminuye conforme avanza la edad. Se encontró alta proporción de portadores con cepas resistentes de neumococo. Los niños que recibieron varios cursos de antimicrobianos, fueron Patients were enrolled in the study during a two-year period from September 1997 to September 1999. All the participants were followed prospectively, swabbing them every four months. The strains recovered were typed and screened for susceptibility to several antibiotics. The daycare records were reviewed also. Odds ratios and fisher's exact test: or chi square test of significance were computed from contingency tables as appropriate. Exact 95% confidence intervals were computed for odds ratios. Data analysis was performed using Epi statistics program version 6.04 a.Results. Pneumococci were recovered from 45/53 of the infants at one or more visits. A total of 178 isolates were carried. The carriage rate was 47%. Only 7 adults acquired pneumococci during the study. Types 6,14,19 and 23 were prevalent and represented 77% of the total. Antibioticresistant strains were higher to penicillin and erythromycin. Conclusions. Children were frequent carriers of pneumococci, the rate of carriage was high in infancy and tended to decrease with age. The types commonly carried by children were the same as those causing invasive disease. There is a high proportion of carriers with antibiotic-resistant S. pneumoniae strains. Children who have had frequent antimicrobial courses are at p...

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High Rate of Nasopharyngeal Carriage of Potential Pathogens Among Children in Greenland: Results of a Clinical Survey of Middle-Ear Disease

Cited by 55 publications

References 39 publications

Study of Two Separate Types of Macrolide-Resistant Mycoplasma pneumoniae Outbreaks

Study of Two Separate Types of Macrolide-Resistant Mycoplasma pneumoniae Outbreaks

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

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