Nasal carriage of common bacterial pathogens among healthy kindergarten children in Chaoshan region, southern China: a cross-sectional study

Abstract

BackgroundNasal colonization with bacterial pathogens is associated with risk of invasive respiratory tract infections, but the related information for Chinese healthy children is scarce.MethodsThis cross-sectional study was conducted with healthy children from 6 kindergartens in the Chaoshan region, southern China during 2011–2012. Nasal swabs were examined for five common bacterial pathogens: Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis, and Staphylococcus aureus.ResultsAmong 1,088 children enrolled, 79.6 % (866) were target-bacterial carriers, of which 34.4 % (298/866) were positive for ≥2 bacteria species. The most common pathogen in the bacterial carriers was M. catarrhalis (76.6 %), followed by S. pneumoniae (26.6 %), S. aureus (21.8 %), H. parainfluenzae (12.7 %), and H. influenzae (2.3 %). Multiple logistic regression analyses showed negative associations between age and the overall or multiple bacterial carriage, and between the father’s education level and multiple bacterial carriage (all p < 0.05). Age was negatively associated with the carriage of M. catarrhalis and S. pneumoniae, and positively associated with the S. aureus carriage (all p < 0.0001).ConclusionsThis study shows high nasal carriage of common pathogenic bacteria and coexistence of multiple pathogens in healthy Chaoshan kindergarten children, with M. catarrhalis as the commonest colonizer. Increasing age of children and higher paternal education are associated with lower risk of bacterial carriage. Longitudinal follow-up studies would be helpful for better understanding the infection risk in bacterial pathogen carriers. Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0703-x) contains supplementary material, which is available to authorized users.

Phenotypic diversity of Haemophilus influenzae and Haemophilus parainfluenzae isolates depending on origin and health condition

“…This result is in agreement with many earlier reports [37,50,30,40]. Furthermore, we observed a greater H. parainfluenzae biotypes diversity (I-VIII) within isolates taken Current Issues in Pharmacy and Medical Sciences from pharyngeal specimens.…”

“…Our results are consistent with literature reports stating that H. parainfluenzae is a significant pathogen associated with various invasive infections [2,11,40,41,52]. Moreover, in our work, a strong predominance of H. influenzae in isolates taken from pharyngeal swabs of healthy children was observed (with approximately 76-89% frequency), while H. parainfluenzae occurred more rarely [31,52].…”

“…Moreover, in our work, a strong predominance of H. influenzae in isolates taken from pharyngeal swabs of healthy children was observed (with approximately 76-89% frequency), while H. parainfluenzae occurred more rarely [31,52]. However, in nasal samples from healthy kindergarten children in China, H. influenzae was a less common pathogen [40].…”

“…These include the pathogenic H. influenzae species. Children under six months of age rarely are the carriers of these bacteria, because of the presence of maternal antibodies protecting against them [10,15,40,48]. However, such passive immunity obtained from the mother's milk does not last long, and 90% of all children >1 year of age are carriers of these bacteria.…”

Factors that are associated with the development of acute respiratory infections in the kindergarten - an analysis of the population of 1,528 children

“…The equal degree of association exists regarding the claim that there are greater chances of ARI when using a commonly used towel (instead of paper towels), as well as when washing blankets less than once a week [17]. Pan et al [18] find that increasing age of children and higher paternal education are associated with lower risk of bacterial carriage.…”