Impact of Antimicrobial Therapy on Nasopharyngeal Carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis in Children with Respiratory Tract Infections

Varon, Emmanuelle; Lévy, Corinne; Rocque, F. De La; Boucherat, M.; Deforche, Dominique; Podglajen, Isabelle; Navel, M.; Cohen, Robert

doi:10.1086/313981

Cited by 82 publications

(62 citation statements)

References 26 publications

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“…Antibiotic use is known to be a major risk factor for the occurrence of resistant bacteria. Several studies have revealed the potential impact of antibiotic use on the increase in the rate of nasopharyngeal carriage of resistant H. influenzae isolates in children (3,6,28,29,40). In our study, the percentage of children who were under treatment for common infantile inflammatory diseases did not differ between the summer and the winter.…”

Section: Discussionmentioning

confidence: 40%

“…The day-care-center (DCC) attendance of children has been reported to be one of the risk factors for URIs, including acute otitis media (1,4,39), and for the nasopharyngeal carriage of bacteria such as H. influenzae and Streptococcus pneumoniae (7,27,32). However, the molecular epidemiology of H. influenzae in the nasopharynx in connection with DCC attendance is not fully understood (5,8,17,27,29,31,32,36,40,42). The aim of this study was to investigate antibiotic resistance-related genetic characteristics and the turnover of nasopharyngeal H. influenzae carriage in children attending DCCs.…”

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confidence: 99%

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Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Hashida¹,

Shiomori²,

Hohchi³

et al. 2008

J Clin Microbiol

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We conducted a prospective bacteriological survey to investigate antibiotic resistance-related genetic characteristics and the turnover of nasopharyngeal Haemophilus influenzae carriage in healthy children in day-care centers (DCCs). A total of 363 nasopharyngeal mucus samples were collected from children aged 0 to 6 years attending two DCCs in the summer of 2004 (n ‫؍‬ 184) and the following winter (n ‫؍‬ 179). We obtained 172 H. influenzae isolates and analyzed them by antimicrobial susceptibility testing, PCR for bla TEM-1 and the penicillin-binding protein (PBP) gene, and pulsed-field gel electrophoresis (PFGE). The overall carriage rate was 47.4% (172/363), and 37.2% of the isolates (64/172) were ampicillin (AMP) resistant. All the resistant isolates had a PBP mutation(s), while only three isolates had TEM-1. The carriage rate was significantly higher in the winter than in the summer (56.4% and 38.6%, respectively), owing to the increase in the numbers of AMP-susceptible H. influenzae isolates in the winter. Children aged <3 years showed a higher rate of carriage of H. influenzae isolates with an AMP resistance gene(s) than those aged >4 years (21.9% and 12.6%, respectively). Forty-two strains with different PFGE patterns were obtained from among the 172 isolates. Only five strains were observed in both seasons. None of the strains isolated in the summer was isolated from the same carrier in the winter. Twenty-seven strains (64.3%) were isolated from two or more children, and 25 of these were each isolated from children belonging to the same DCC. These results indicate the spread of H. influenzae, particularly those with a PBP mutation(s), and the highly vigorous genetic turnover and substantial horizontal transmission of this pathogen in healthy children attending DCCs in Japan.

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Section: Discussionmentioning

confidence: 40%

mentioning

confidence: 99%

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Hashida¹,

Shiomori²,

Hohchi³

et al. 2008

J Clin Microbiol

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“…Nasopharyngeal carriage of drug resistant S. pneumoniae can serve as an indicator of the prevalence of resistant strains in community and has been used to assess the resistance of S. pneumoniae and H. influenzae in different populations (Fairchok et al 1996;Kellner & Ford-Jones 1999;Varon et al 1999). The aims of this study were to estimate the carriage rate of these two organisms in normal schoolchildren and prevalence of resistance to various antimicrobial drugs among H. influenzae and S. pneumoniae in northern Indian children.…”

Section: Introductionmentioning

confidence: 99%

High nasopharyngeal carriage of drug resistant Streptococcus pneumoniae and Haemophilus influenzae in North Indian schoolchildren

Jain

Kumar

Awasthi

2005

Trop Med Int Health

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Summaryobjectives To determine the carriage rate of Streptococcus pneumoniae and Haemophilus influenzae in healthy Indian schoolchildren. The prevalence of antibiotic resistant strains in the community may be used to assess the trends of antibiotic resistance in invasive strains. Prevalence of resistance to various antimicrobial drugs among S. pneumoniae and H. influenzae was estimated.methods Two thousand four hundred subjects, aged 5-10 years, were enrolled from 45 rural and 45 urban schools. A nasopharyngeal swab was collected from each child, after taking informed written consent. Swabs were processed to isolate S. pneumoniae and H. influenzae. All isolates were tested for resistance to chloramphenicol, erythromycin and co-trimoxazole. Streptococcus pneumoniae isolates were also tested against tetracycline and oxacillin while H. influenzae isolates were tested against ampicillin.results Nasopharyngeal carriage of S. pneumoniae and H. influenzae was high in healthy schoolchildren. Stratified analysis showed that nasal carriage of pneumococci in urban children was significantly lower than in rural children [46.8% vs. 53.2%, P < 0.001]. Carriage rates of H. influenzae in male and female populations were significantly different (47.8% vs. 52.3%, P < 0.04). Penicillin resistance in S. pneumoniae was found low (3.3%), but 22.9% of H. influenzae isolates were ampicillin resistant. Resistance to co-trimoxazole was very high in both S. pneumoniae (81.8%) and H. influenzae (67.3%).conclusion There is high nasopharyngeal carriage of drug resistant S. pneumoniae and H. influenzae in schoolchildren of north India. Currently, in India, co-trimoxazole for 5 days is recommended for treatment of non-severe pneumonia and third generation cephalosporins are drug of choice for management of severe pneumococcal/H. influenzae diseases. We found high co-trimoxazole resistance and low penicillin resistance in pneumococcal isolates. This justifies empirical use of penicillin in management of invasive pneumococcal infections in India.

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“…Acute respiratory illnesses were shown to increase colonization rates of both pathogens (2,13). Recent antibiotic treatment decreased total carriage while increasing carriage rates of antibiotic-resistant pathogens (28).…”

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Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

Greenberg¹,

Broides

Blancovich³

et al. 2004

J Clin Microbiol

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Streptococcus pneumoniae and Haemophilus influenzae carriage is a useful index for measuring the emergence of resistance and outcome in vaccination trials. We performed a study to determine which sampling site, nasopharynx (NP) or oropharynx (OP), yields the highest rate of S. pneumoniae and H. influenzae isolation at different ages. Both NP and OP cultures were obtained from 216 children aged <60 months and their mothers. The total S. pneumoniae carriage rate was 68% among children and 15% among mothers (P < 0.001). Using NP alone for the isolation of S. pneumoniae would have missed 2, 2, and 42% and using OP alone would have missed 77, 66, and 45% of S. pneumoniae in children aged 0 to 23 months, 24 to 59 months, and mothers, respectively. Using NP cultures alone for H. influenzae would have missed 23, 24, and 81% of the isolates, respectively. The respective figures for H. influenzae isolation from OP alone are 38, 29, and 9%. In children, S. pneumoniae was carried mainly in the NP while H. influenzae was equally carried in the NP and OP. In mothers, S. pneumoniae was carried equally in the NP and OP while H. influenzae was carried significantly more often in the OP. In children, H. influenzae colonization increased during illness, mainly in the NP. Culturing only one site significantly reduced the recovery of H. influenzae at all ages. NP cultures for S. pneumoniae detected close to 100% of isolates in children but only 58% of isolates in mothers.Streptococcus pneumoniae and Haemophilus influenzae are important bacterial pathogens causing infections in young children and in elderly patients (1,22,23). Both organisms commonly colonize the mucosal membrane of the nasopharynx and throat of healthy children, and most children are colonized at some point during the first 2 years of life (10, 15). Information on the nasopharyngeal (NP) and oropharyngeal (OP) carriage rate of both organisms is crucial to understanding disease epidemiology, since these organisms can spread from colonized sites to adjacent mucosal tissues to cause mucosal infections or, in the case of S. pneumoniae, invade the bloodstream to cause bacteremia and meningitis. In addition to carriage in the upper respiratory tract, the organism can spread from person to person (16,17,24). Furthermore, studying the organisms carried in the upper respiratory tract provides useful information on the emergence of resistance in clinical isolates (18,27). It is also important to evaluate the mucosal carriage of the organisms in vaccine trials as an index of potential herd protection.Nasopharyngeal sampling is considered superior to OP sampling for detecting S. pneumoniae, especially in young children (25), but there are other contradictory results showing that in adults OP sampling yields higher isolation rates (4, 16). Only a few carriage studies have directly compared different sampling methods for the detection of S. pneumoniae and H. influenzae (4, 6, 25; R. Dagan, O. Zamir, M. Sikuler-Cohen, P. Yagupsky, P. Peeters, and M. Hohenboken, Abstr. 41st Intersc...

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Impact of Antimicrobial Therapy on Nasopharyngeal Carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis in Children with Respiratory Tract Infections

Cited by 82 publications

References 26 publications

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

Nasopharyngeal Haemophilus influenzae Carriage in Japanese Children Attending Day-Care Centers

High nasopharyngeal carriage of drug resistant Streptococcus pneumoniae and Haemophilus influenzae in North Indian schoolchildren

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

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