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Clinical characteristics of children with lower respiratory tract infections are dependent on the carriage of specific pathogens in the nasopharynx

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Abstract

A prospective clinical study was performed to correlate nasopharyngeal carriage of bacteria with the type of lower respiratory tract infections (LRTI) in hospitalised children. To determine bacterial load in nasopharyngeal aspirates (NPA) we used semiquantitative culturing and quantitative TaqMan-PCR for those pathogens difficult to culture. Specimens and clinical data were obtained from 311 children between 0 and 16 years of age with LRTI during the period of 2006–2008. The most common detected potentially pathogenic colonisers were Haemophilus influenzae (32.1 %), Moraxella catharralis (26.7 %), Staphylococcus aureus (17.7 %) and Streptococcus pneumoniae (16.7 %). As expected S. aureus was the most common coloniser in children less than 4 months of age, whereas H. influenzae detection peaked in older children. Co-colonisation with other bacterial pathogens were more often observed in children with S. aureus (46 %) and S. pneumoniae (49 %) than in those with H. influenzae (30 %) or M. catharralis (27 %). Children with S. aureus co-colonisation had higher levels of C-reactive-protein, received antibiotics more frequently and stayed longer in hospital than those with S. aureus single colonisation. In contrast, children with H. influenzae, M. catharralis or S. pneumoniae colonisation suffered more often from pneumonia than children with S. aureus colonisation. Coloniser specific analysis of bacterial quantity revealed no significant reduction of the bacterial carriage from the first to the second NPA. No correlation of a high bacterial load and occurrence of pneumonia could be detected. In conclusion, clinical characteristics in children with LRTIs are associated with a specific bacterial set of colonisers detected in the nasopharynx rather than on their quantity.

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Acknowledgment

We would like to thank all participating physicians, nurses and technical staff for recruiting and treating the patients, obtaining the NPAs and performing the assays.

Competing interests

The authors declare that they have no conflict of interest.

Authors' contributions

TT, AF, NN, RW, BH participated in the design, data collection and analysis, and drafted the manuscript; HS SSK, OA, contributed to the interpretation of the data and editing of the manuscript and supervised the design and execution of the study; JB performed the statistical analysis. The final version of the manuscript was approved by all of the authors.

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Authors and Affiliations

  1. Paediatric Infectious Diseases, Department of Paediatrics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    T. Tenenbaum & H. Schroten

  2. Department of Paediatrics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

    A. Franz & R. Willems

  3. Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

    N. Neuhausen & B. Henrich

  4. Department of Biostatistics, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany

    J. Brade

  5. Children’s Hospital, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany

    S. Schweitzer-Krantz

  6. Institute of Virology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

    O. Adams

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  1. T. Tenenbaum
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Correspondence to T. Tenenbaum.

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Tenenbaum, T., Franz, A., Neuhausen, N. et al. Clinical characteristics of children with lower respiratory tract infections are dependent on the carriage of specific pathogens in the nasopharynx. Eur J Clin Microbiol Infect Dis 31, 3173–3182 (2012). https://doi.org/10.1007/s10096-012-1682-y

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  • DOI: https://doi.org/10.1007/s10096-012-1682-y

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