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

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

Research output: Contribution to journalArticle

Abstract

Objectives. To assess risk factors for nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in a large sample of healthy children. Methods. In this point prevalence survey nasopharyngeal specimens were obtained from 1723 healthy children, ages 1 to 7 years, attending day-care centers or schools in 18 Italian cities. Written questionnaires for obtaining information about the demographics and medical history of the children were completed by the parents in the presence of a pediatrician. Results. The overall carrier rate of respiratory pathogens was 17.9% (S. pneumoniae, 3.5%; H. influenzae, 11.9%; M. catarrhalis, 4.1%). Only 5% of S. pneumoniae strains were penicillin-resistant whereas ~40% were erythromycin-resistant. Beta-lactamase production was found in 5.8% of H. influenzae and 88.7% of M. catarrhalis isolates. By multivariate analysis age (≤3 years), having older siblings, a history of prolonged full-time day- care attendance and living in a rural area significantly influenced the odds of carrying nasopharyngeal respiratory pathogens, particularly in children ages 1 to 5 years. Sex, breastfeeding, passive smoking and recent upper respiratory tract infections were not significant variables. Antibiotic treatment in the previous 3 months did not affect nasopharyngeal carriage, whereas repeated treatments with a macrolide were associated with carriage of S. pneumoniae. Conclusions. Our results suggest that there is a strong and long term relationship between exposure to large numbers of children in the first years of life and nasopharyngeal carriage of all respiratory pathogens. In addition antimicrobial restrictive guidelines should be tailored to local microbiologic sceneries.

Original languageEnglish
Pages (from-to)517-523
Number of pages7
JournalPediatric Infectious Disease Journal
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 1999

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Nasopharynx
Streptococcus pneumoniae
Moraxella (Branhamella) catarrhalis
Haemophilus influenzae
Tobacco Smoke Pollution
Macrolides
Erythromycin
beta-Lactamases
Respiratory Rate
Breast Feeding
Respiratory Tract Infections
Penicillins
Siblings
Multivariate Analysis
Parents
Demography
Guidelines
Anti-Bacterial Agents
Therapeutics

Keywords

  • Bacterial resistance
  • Epidemiology
  • Nasopharyngeal carriage
  • Respiratory pathogens

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. / Principi, Nicola; Marchisio, Paola; Schito, Gian Carlo; Mannelli, Stefania.

In: Pediatric Infectious Disease Journal, Vol. 18, No. 6, 06.1999, p. 517-523.

Research output: Contribution to journalArticle

Principi, Nicola ; Marchisio, Paola ; Schito, Gian Carlo ; Mannelli, Stefania. / Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. In: Pediatric Infectious Disease Journal. 1999 ; Vol. 18, No. 6. pp. 517-523.
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