Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children

Principi, Nicola; Marchisio, Paola; Schito, Gian Carlo; Mannelli, Stefania

doi:10.1097/00006454-199906000-00008

Cited by 186 publications

(187 citation statements)

References 34 publications

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of nasopharyngeal Hi at the day care center investigated was quite high (77%) when compared with the nasopharyngeal frequency among Italian children [25], but was similar to colonization rates reported for American children [26]. The biotypes isolated, I, II and III, agree with those reported by others [27].…”

Section: Discussionsupporting

confidence: 87%

An epidemiological study of Haemophilus influenzae at a Brazilian day care center

Me¹,

Jm²

2001

Braz J Infect Dis

View full text Add to dashboard Cite

Day care centers are a relatively new phenomenon in Brazil that bring together large numbers of young children susceptible to contagious diseases. Haemophilus influenzae (Hi) is an important infection in the age range of those attending day care centers. In the present study, the carriage rate of Haemophilus influenzae was identified in 38 day care attendees age 6 to 37 months, and 23 staff members, at a day care center in Ribeirão Preto-São Paulo, in 1997. To identify the carriers, two nasopharyngeal swabs were collected; one in July and one in December. The rate of H. influenzae carriers among the children was 77%. Only 2 of 23 staff members (9%) had Hi. Among the children, there were 58 isolates in the two sampling periods; 6 of the Hi were serotype b, 1 was serotype e, and 48 isolates were non-typeable. Two were identified as H. parainfluenzae. One adult had a non-typeable Hi and 1 had H. paraphrohaemolyticus. Three of the 6 children with type B had received a conjugate vaccine against H. influenzae type b, but they still carried this bacterium in the nasopharynx (50%). Forty ribotype patterns were found among the isolates, showing a high exchange rate of nontypeable H. influenzae carriers. The results indicate that, because of the high and changing biotype of Hi carriage, day care centers should be carefully monitored as potential point source of HI disease in the community.

show abstract

Section: Discussionsupporting

confidence: 87%

An epidemiological study of Haemophilus influenzae at a Brazilian day care center

Me¹,

Jm²

2001

Braz J Infect Dis

View full text Add to dashboard Cite

show abstract

“…The analysis of this absolute risk among members of a community, dependent on both the fraction of resistant S pneumoniae and the rate of carriage, is more important in gauging the public health and clinical impacts of antibiotic resistance. Attendance at group child care has been a consistently identified risk factors for S pneumoniae 39 and PNSP colonization in previous studies 10 and is a strong predictor in our sample as well (OR: 3.9). Previous antibiotic use, especially of low dosage and long duration, has been associated with increased risk of carriage of resistant S pneumoniae as well.…”

Section: Discussionsupporting

confidence: 67%

Antibiotic-Resistant Streptococcus pneumoniae in the Heptavalent Pneumococcal Conjugate Vaccine Era: Predictors of Carriage in a Multicommunity Sample

et al. 2003

View full text Add to dashboard Cite

Objective. Despite immunization with heptavalent pneumococcal conjugate vaccine (PCV7), the rising prevalence of antibiotic resistance makes Streptococcus pneumoniae a continuing threat to child health. Data on carriage of resistant organisms by healthy children in communities in which immunization with PCV7 has been implemented will help to define and decrease these risks further. Methods. Children who were <7 years old, resided in a study community, and presented for routine well care or a “sick” visit between March 13 and May 11, 2001, at 31 primary care practices in 16 geographically distinct Massachusetts communities were studied. Consenting parents provided demographic information and data on potential risk factors for carriage of S pneumoniae and of penicillin-nonsusceptible S pneumoniae (PNSP). S pneumoniae isolates from nasopharyngeal specimens were tested for resistance to commonly used antibiotics including penicillin, ceftriaxone, erythromycin, and trimethoprim/sulfamethoxazole. Isolates were serotyped and grouped into PCV7-included serotypes, potentially cross-reactive serotypes (ie, an organism of a serogroup included in the vaccine), or non-PCV7 serotypes. Diagnosis on the day of collection, history of recent antibiotic use, and history of PCV7 immunization were obtained by chart review. Separate bivariate and multivariate analyses were performed to identify correlates of colonization with S pneumoniae and colonization with PNSP, accounting for clustering within communities. Results. S pneumoniae was isolated from the nasopharynx of 190 (26%) of the 742 children studied. Of the 166 tested, 33% were nonsusceptible to penicillin, with 14% showing intermediate susceptibility (minimum inhibitory concentration [MIC] 0.12–1.0) and 19% fully resistant (MIC ≥2). Nonsusceptibility to other antibiotics was common, including ceftriaxone (14%), erythromycin (22%), and trimethoprim/sulfa (31%); 20% of S pneumoniae isolates were not susceptible to ≥3 antibiotics. Thirty-six percent of isolates were of serotypes covered by PCV7; 30% were of PCV7 serogroups and potentially cross-reactive, but not 1 of the 7 included serotypes; and 34% were unrelated to PCV7 serogroups. Nonsusceptibility to penicillin was more common in PCV7-included strains (45%) and potentially cross-reactive strains (51%) than in non-PCV7 serotypes (8%). Risk factors for PNSP colonization included child care attendance (odds ratio [OR]: 3.9; 95% confidence interval [CI]: 2.3–6.5), current respiratory tract infection (OR: 4.7; 95% CI: 2.5–8.6), and recent antibiotic use (OR: 1.7; 95% CI: 1.0–2.8). PCV7 immunization was associated with decreased carriage of PCV7-included serotypes but not with an overall decrease in S pneumoniae colonization or with a decline in PNSP colonization. Conclusions. In this multicommunity sample, pneumococcal antibiotic resistance was common and was most frequently found in PCV7-included and PCV7 serogroup strains. The long-term impact of PCV7 immunization will be partially determined by the protection that it affords against invasive infection with potentially cross-reactive serotypes, as well as the virulence and future resistance patterns of unrelated serotypes.

show abstract

“…Having no siblings or only older siblings would tend to reduce exposure to younger children explaining the lower carriage rates. Although many studies have reported higher rates of carriage in children in pre-school and primary school [16,19], a low carriage rate in young children was reported in a recent large study in Italy [28]. These authors suggested the low rate may be due to sampling of healthy children.…”

Section: Discussionmentioning

confidence: 91%

“…However, an increase of carriage in early school years has been reported [28], which may reflect contact with other children who are carriers. Having no siblings or only older siblings would tend to reduce exposure to younger children explaining the lower carriage rates.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Boost

O'Donoghue

Dooley³

2001

Epidemiol. Infect.

View full text Add to dashboard Cite

SUMMARYA cross-sectional survey was conducted to determine prevalence and assess risk factors for carriage of antibiotic resistant strains of Streptococcus pneumoniae in healthy school children in Hong Kong. Throat swabs were collected from 1455 subjects and written questionnaires providing demographic data and medical history were completed by parents. The overall carriage rate of Streptococcus pneumoniae was 3n5 %, of which 49 % were penicillin resistant. High levels of resistance to tetracycline (73 %), erythromycin (52 %), trimethoprim (66 %) and ciprofloxacin (57 %) were observed. Carriage was associated with presence of a younger sibling (OR l 1n79) and use of antibiotics (OR l 2n31). High use of day care and small size of housing units did not result in a high rate of carriage. The low rate of carriage may be linked to high use of antibiotics, geographical factors or ethnicity. High rates of antibiotic resistance reflect heavy use of antibiotics by general practitioners.

show abstract

Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children

Cited by 186 publications

References 34 publications

An epidemiological study of Haemophilus influenzae at a Brazilian day care center

An epidemiological study of Haemophilus influenzae at a Brazilian day care center

Antibiotic-Resistant Streptococcus pneumoniae in the Heptavalent Pneumococcal Conjugate Vaccine Era: Predictors of Carriage in a Multicommunity Sample

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

Contact Info

Product

Resources

About