Sleeping position and upper airways bacterial flora: relevance to cot death.

Bell, S A; Crawley, B.; Oppenheim, Beryl; Drucker, D.B.; Morris, J A

doi:10.1136/jcp.49.2.170

Cited by 27 publications

(16 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the second part of the study, in infants aged 12–18 months there were a number of observations which are pertinent to SIDS and the common bacterial toxin hypothesis. A prediction of the hypothesis is that when infants sleep prone secretions will pool in the upper airways leading to increased bacterial growth and toxin production [18]. If infants sleep supine, the secretions will drain under gravity into the oesophagus and bacterial growth will be less.…”

Section: Discussionmentioning

confidence: 99%

The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position

Harrison

Morris

Telford

et al. 1999

FEMS Immunology &Amp; Medical Microbiology

119

View full text Add to dashboard Cite

The aim of the investigation was to determine the effect of age, gender, viral upper respiratory tract infection (URTI), season and sleeping position on the composition of the nasopharyngeal bacterial flora in infancy. Seventy-two babies, 38 male and 34 female, whose birthdates were evenly spread throughout the year were followed from birth to 18 months of age. From 0 to 6 months nasopharyngeal swabs were obtained once a month in periods without URTI and daily for 3 days during episodes of URTI. From 12 to 18 months of age nasopharyngeal swabs were obtained in the early morning alter an overnight sleep and later in the day after the baby had been up for over 2 h. Swabs were obtained in prone and supine sleepers with and without infection. In infants aged 0-6 months URTI had little effect on the nasopharyngeal bacterial flora, but there was a marked effect of age and less marked effect of season and gender. In particular Staphylococcus aureus carriage decreased with age, was most common in the winter months and the density of colonisation was greater in males than females. In infants aged 12-18 months the combination of prone sleeping with URTI and an early morning swab led to increased carriage of staphylococci, streptococci. Haemophilus influenzae and Gram-negative bacilli which are not normally part of the nasopharyngeal flora. These results are relevant to sudden infant death syndrome (SIDS). The combination of prone sleeping and URTI reproduces the nasopharyngeal flora seen in SIDS. Gram-negative bacilli isolated from SIDS cases should not be dismissed as post-mortem contaminants. The features of S. aureus make it a prime candidate for a pathogenic role in SIDS.

show abstract

Section: Discussionmentioning

confidence: 99%

The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position

Harrison

Morris

Telford

et al. 1999

FEMS Immunology &Amp; Medical Microbiology

119

View full text Add to dashboard Cite

show abstract

“…Moreover, a study in adults with colds revealed increased bacterial growth in the upper respiratory tract (by nasal swabs) in individuals lying prone versus supine. 5 We believe the possible interrelationships between day care center-related SIDS, prone sleep position, and H pylori infection merit further investigation from multiple scientific disciplines.…”

Section: Sids Licensed Care Centers and Helicobacter Pylorimentioning

confidence: 99%

Underreporting of Pertussis Deaths in the United States: Need for Improved Surveillance

Shaikh¹,

Güriş²,

Strebel³

et al. 1998

PEDIATRICS

View full text Add to dashboard Cite

“…The above argument is theoretical but an investigation has been conducted in adult volunteers, aged 19–35 years, with colds [32]. They were asked to lie prone for 1 h and then supine for 1 h. At the end of each period, a nasal swab was obtained and bacterial counts were performed.…”

Section: Investigating the Hypothesismentioning

confidence: 99%

The common bacterial toxins hypothesis of sudden infant death syndrome

Morris

1999

FEMS Immunology &Amp; Medical Microbiology

View full text Add to dashboard Cite

The background to the common bacterial toxin hypothesis of sudden infant death syndrome is presented. The idea is that some cases of sudden infant death syndrome are due to the lethal effects of nasopharyngeal bacterial toxins which can act synergistically to trigger the events leading to death. The concept is consistent with the age distribution of sudden infant death syndrome, the winter excess of cases and the role of prone sleeping and passive exposure to cigarette smoke. A number of laboratory-based investigations are described. There is an increased isolation of staphylococci and Gram-negative bacilli from sudden infant death syndrome infants compared with age- and season-matched healthy infants. Bacteria from sudden infant death syndrome infants interact synergistically to cause sudden death in gnotobiotic weanling rats. Bacterial toxins implicated in sudden infant death syndrome interact synergistically to cause death in chick embryos. Nicotine in very low doses potentiates the lethal effect of toxin combinations in chick embryos. Staphylococcal toxins and endotoxins have been demonstrated in sudden infant death syndrome tissues, antibodies to endotoxins are low in sudden infant death syndrome cases and the prone sleeping position leads to pooling of secretions in the upper airways, increasing the risk of bacterial growth and toxin production. If the hypothesis is correct, then there is the possibility of a further reduction in the incidence of sudden infant death syndrome based on immunisation against the toxins involved.

show abstract

Sleeping position and upper airways bacterial flora: relevance to cot death.

Cited by 27 publications

References 7 publications

The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position

The nasopharyngeal bacterial flora in infancy: effects of age, gender, season, viral upper respiratory tract infection and sleeping position

Underreporting of Pertussis Deaths in the United States: Need for Improved Surveillance

The common bacterial toxins hypothesis of sudden infant death syndrome

Contact Info

Product

Resources

About