Skip to main content

Advertisement

SpringerLink
Log in

Study of nasopharyngeal bacterial flora. Variations in nasopharyngeal bacterial flora in schoolchildren and adults when administered antimicrobial agents

  • ORIGINAL ARTICLE
  • Published:
Journal of Infection and Chemotherapy

Abstract

Changes in nasopharyngeal bacterial flora in adults with acute upper respiratory tract infection on administration of antimicrobial agents were investigated, and how these changes contrasted with those in children. Many patients with acute sinusitis due to allergies, and patients with malignancy and diabetes mellitus were included in the investigation. The detection rates of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the major bacteria of acute otitis media (AOM), were 22%, 10%, and 7% respectively, which were significantly lower than those for children. Gram stain examination of nasopharyngeal swab samples showed a significant relation between leukocyte infiltration and the detection amount of S. pneumoniae (P = 0.0086). A significant relation (P = 0.0134) was also observed when H. influenzae was simultaneously detected. No significant change in the three major AOM bacteria present in nasopharyngeal bacterial flora after administration of antimicrobial agents was observed. However, all S. pneumoniae and H. influenzae detected after antimicrobial agent administration had the β-lactam-resistance gene. It was observed that a significant improvement in leukocyte infiltration occurred 6 to 10 days after antimicrobial agent administration. In contrast, a significant improvement in children was observed at 2 to 5 days. In the adult subjects, this improvement was probably due to spontaneous remission rather than the effect of the antimicrobial agents. Although investigation of the long-term administration of antimicrobial agents was also conducted, its benefits for the patients were not elucidated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SF Dowell SM Marcy WR Philips MA Gerber B Schwartz (1998) ArticleTitlePrinciple of judicious use of antimicrobial agents for pediatrics upper respiratory tract infections Pediatrics 101 IssueIDSuppl 163–5

    Google Scholar 

  2. Subcommittee on Management of Acute Otitis Media: diagnosis and management of acute otitis media. Pediatrics 2004;113:1451–65

    Google Scholar 

  3. L Vemacchio RM Vezina AA Mitchell (2006) ArticleTitleKnowledge and practices relating to the 2004 acute otitis media clinical practice guideline: a survey of practicing physicians Pediatr Infect J 25 385–9 Occurrence Handle10.1097/01.inf.0000214961.90326.d0

    Article  Google Scholar 

  4. N Segal E Leibovitz R Dagan A Leiberman (2005) ArticleTitleAcute otitis media–diagnosis and treatment in the era of antibiotic resistant organisms: updated clinical practice guidelines Int J Pediatr Otorhinolaryngol 69 1311–9 Occurrence Handle15955573 Occurrence Handle10.1016/j.ijporl.2005.05.003

    Article  PubMed  Google Scholar 

  5. AE Akkerman MM Kuyvenhoven JC van der Wouden TJ Verheij (2005) ArticleTitleAnalysis of under- and overprescribing of antibiotics in acute otitis media in general practice J Antimicrob Chemother 56 569–74 Occurrence Handle16033803 Occurrence Handle10.1093/jac/dki257 Occurrence Handle1:CAS:528:DC%2BD2MXpvFGqurg%3D

    Article  PubMed  CAS  Google Scholar 

  6. SL Woolley DR Smith (2005) ArticleTitleAcute otitis media in children – there are guildelines but are they followed? J Laryngol Otol 119 524–8 Occurrence Handle16175976 Occurrence Handle10.1258/0022215054352289 Occurrence Handle1:STN:280:DC%2BD2MrgsVSisQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  7. AL Ander R Eggertsen (2004) ArticleTitleAcute otitis media is not treated according to recommendations. Survey of treatment patterns in emergency centers and community health centers Lakartidningen 101 3142–6 Occurrence Handle15517708

    PubMed  Google Scholar 

  8. AJ Brink MF Cotton C Feldman L Geffen W Hendson MH Hockman et al. (2004) ArticleTitleGuideline for management of upper respiratory tract infections S Afr Med J 94 475–83 Occurrence Handle15244257 Occurrence Handle1:STN:280:DC%2BD2czkt1Snsw%3D%3D

    PubMed  CAS  Google Scholar 

  9. E Sanz MA Hernandez M Kumari S Ratchina L Stratchounsky MA Peire et al. (2004) ArticleTitlePharmacological treatment of acute otitis media in children. A comparison among seven locations: Tenerif, Barcelona and Valencia (Spain), Toulouse (France), Smolensk (Russia), Bratislava (Slovakia) and Sofia (Bulgaria) Eur J Clin Phamacol 60 37–43 Occurrence Handle10.1007/s00228-003-0720-1 Occurrence Handle1:CAS:528:DC%2BD2cXitVOiurc%3D

    Article  CAS  Google Scholar 

  10. M Konno K Ubukata (1999) Penicillin-resistant Streptococcus pneumoniae M Konno K Ubukata (Eds) Revised edition: penicillin-resistant Streptococcus pneumoniae Kyowa Kikaku Tokyo 1–157

    Google Scholar 

  11. InstitutionalAuthorNameStudy group for Community Acquired Infection Caused by Streptococcus pneumoniae (1999) ArticleTitleCommunity acquired infection for which reexamination is pressed. – Let PRSP and BLNAR infection be subjects Jpn J Antibiotics 52 IssueIDSuppl B 2–120

    Google Scholar 

  12. InstitutionalAuthorNameStudy group for Community Acquired Infection Caused by Streptococcus pneumoniae (2001) ArticleTitleCommunity acquired infection for which reexamination is pressed. – Let PRSP and BLNAR infection be subjects, 2nd report Jpn J Antibiotics 54 IssueIDSuppl B 4–111

    Google Scholar 

  13. M Konno K Ubukata N Chiba K Hasegawa Y Shibasaki K Sudoh et al. (2001) ArticleTitlePostmarketing special investigation and verification of precision for cefditoren pivoxil Jpn J Chemother 49 369–96

    Google Scholar 

  14. InstitutionalAuthorNameStudy Group for Upper Respiratory Tract Bacterial Flora (2005) ArticleTitleBacterial dynamics of nasopharynx Jpn J Antibiotics 58 IssueIDSuppl A 2–130

    Google Scholar 

  15. M Konno S Baba H Mikawa K Hara F Matsumoto K Kaga et al. (2006) ArticleTitleStudy of upper respiratory tract bacterial flora: first report. Variations in upper respiratory tract bacterial flora in patients with acute upper respiratory tract infection and healthy subjects, and variation by subject age J Infect Chemother 12 83–96 Occurrence Handle16648948 Occurrence Handle10.1007/s10156-006-0433-3

    Article  PubMed  Google Scholar 

  16. M Konno S Baba H Mikawa K Hara F Matsumoto K Kaga et al. (2006) ArticleTitleStudy of nasopharyngeal bacterial flora: second report. Variations in nasopharyngeal bacterial flora in children aged 6 years or younger when administered antimicrobial agents. Part 1 J Infect Chemother 12 287–304 Occurrence Handle17109094 Occurrence Handle10.1007/s10156-006-0468-5

    Article  PubMed  Google Scholar 

  17. Konno M, Baba S, Mikawa H, Hara K, Matsumoto F, Kaga K, et al. Study of nasopharyngeal bacterial flora: second report. Variations in nasopharyngeal bacterial flora in children aged 6 years or younger when administered antimicrobial agents. Part 2. J Infect Chemother 2006;305–30

  18. K Ubukata Y Shibasaki K Yamamoto N Chiba K Hasegawa K Takeuchi et al. (2001) ArticleTitleAssociation of amino acid substitutions in penicillin-binding protein 3 with β-lactam resistance in β-lactamase-negative ampicillin-resistant Haemophilus influenzae Antimicrob Agents Chemother 45 1693–9 Occurrence Handle11353613 Occurrence Handle10.1128/AAC.45.6.1693-1699.2001 Occurrence Handle1:CAS:528:DC%2BD3MXjslyqs7o%3D

    Article  PubMed  CAS  Google Scholar 

  19. N Yamanaka H Faden (1993) ArticleTitleAntibody response to outer membrane protein of nontypeable Haemophilus influenzae in otitis prone children J Pediatr 122 212–8 Occurrence Handle8429433 Occurrence Handle1:STN:280:DyaK3s7lsFyhuw%3D%3D

    PubMed  CAS  Google Scholar 

  20. M Hotomi N Yamanaka T Saito J Shimada M Suzumoto M Suetake et al. (1999) ArticleTitleAntibody responses to the outer membrane protein P6 of nontypeable Haemophilus influenzae and pneumococcal capsular polysaccharides in otitis children Acta Otolaryngol 119 703–7 Occurrence Handle10587005 Occurrence Handle10.1080/00016489950180667 Occurrence Handle1:CAS:528:DC%2BD3MXitlOmtbs%3D

    Article  PubMed  CAS  Google Scholar 

  21. R Veenhoven G Rukers A Schilder J Adelmeijer C Uiterwaal W Kuis et al. (2004) ArticleTitleImmunoglobulins in otitis-prone children Pediatr Res 55 159–62 Occurrence Handle14561788 Occurrence Handle10.1203/01.PDR.0000099776.66136.39 Occurrence Handle1:CAS:528:DC%2BD3sXpslOjurg%3D

    Article  PubMed  CAS  Google Scholar 

  22. U Schauer F Stemberg CH Rieger W Buttner M Borte S Schubert et al. (2003) ArticleTitleLevels of antibodies specific to tetanus toxoid, Haemophilus influenzae type b, and pneumococcal capsular polysaccharide in healthy children and adults Clin Diagn Lab Immunol 10 202–7 Occurrence Handle12626443 Occurrence Handle10.1128/CDLI.10.2.202-207.2003 Occurrence Handle1:CAS:528:DC%2BD3sXislWiu7Y%3D

    Article  PubMed  CAS  Google Scholar 

  23. L Kaiser B Hirschel R Auckenthaler A Morabia A Heald P Benedict et al. (1996) ArticleTitleEffects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions Lancet 347 1507–10 Occurrence Handle8684101 Occurrence Handle10.1016/S0140-6736(96)90670-4 Occurrence Handle1:CAS:528:DyaK28XjvVyrurk%3D

    Article  PubMed  CAS  Google Scholar 

  24. R Gonzales JG Bartlett RE Besser JM Hinckner JR Hoffman MA Sande et al. (2001) ArticleTitlePrinciple of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infection in adults: background Ann Intern Med 134 490–4 Occurrence Handle11255526 Occurrence Handle1:STN:280:DC%2BD3M7mt1Klug%3D%3D

    PubMed  CAS  Google Scholar 

  25. JM Hinckner JG Bartlett RE Besser R Gonzales JR Hoffman et al. (2001) ArticleTitlePrinciple of appropriate antibiotic use for acute rhinosinusitis in adults: background Ann Intern Med 134 498–505

    Google Scholar 

  26. RJ Cooper JR Hoffman JG Bartlett RE Besser R Gonzales et al. (2001) ArticleTitlePrinciple of appropriate antibiotic use for acute pharyngitis in adults: background Ann Intern Med 134 509–17 Occurrence Handle11255530 Occurrence Handle1:STN:280:DC%2BD3M7mt1KksA%3D%3D

    PubMed  CAS  Google Scholar 

  27. R Gonzales JG Bartlett RE Besser RJ Cooper JM Hincker JR Hoffman et al. (2001) ArticleTitlePrinciple of appropriate antibiotic use for treatment of uncompleted acute bronchitis: background Ann Intern Med 134 521–9 Occurrence Handle11255532 Occurrence Handle1:STN:280:DC%2BD3M7mt1Kktg%3D%3D

    PubMed  CAS  Google Scholar 

  28. JJ Farmer SuffixIII (2003) Enterobacteriaceae: introduction and identification PR Murray EJ Baron MA Pfaller JH Jorgensen RH Yolken (Eds) Manual of clinical microbiology, 8th ed American Society for Microbilogy Wsashington, DC 636–653

    Google Scholar 

  29. K Ubukata (1999) ArticleTitleCommunity acquired infection for which reexamination is pressed. – Problem institution for the bacteriological examination Jpn J Antibiotics 52 IssueIDSuppl B 4–13

    Google Scholar 

  30. K Ubukata (1999) ArticleTitleCommunity acquired infection for which reexamination is pressed. – Verification to the accuracy of bacteriological examination: evaluation to the sample sent from each study group member Jpn J Antibiotics 52 IssueIDSuppl B 84–9

    Google Scholar 

  31. K Nagai Y Shibasaki K Hasegawa TA Davies MR Jacob K Ubukata PC Appelbaum (2001) ArticleTitleEvalution of PCR primers to screen for Streptococcus pneumoniae isolates and β-lactam resistance, and to detect common macrolide resistance determinants J Antimicrob Chemother 48 915–8 Occurrence Handle11733479 Occurrence Handle10.1093/jac/48.6.915 Occurrence Handle1:CAS:528:DC%2BD38Xjt1ehsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  32. R Kobayashi M Konomi K Hasegawa M Morozumi K Sunakawa K Ubukata (2005) ArticleTitleIn vitro activity of tebipenem, a new oral carbapenem antibiotic, against penicillin-nonsusceptible Streptococcus pneumoniae Antimicrob Agents Chemother 49 889–94 Occurrence Handle15728880 Occurrence Handle10.1128/AAC.49.3.889-894.2005 Occurrence Handle1:CAS:528:DC%2BD2MXit12mt7c%3D

    Article  PubMed  CAS  Google Scholar 

  33. Hasegawa K, Chiba N, Kobayashi R, Murayama SY, Iwata S, Sunakawa K, et al. Rapidly increasing prevalence of β-lactamase-nonproducing, ampicillin-resistant Haemophilus influenzae type b in patients with meningitis. Antimicrob Agents Chemother 2004;1509–14

  34. R Gonzales JG Bartlett RE Besser RJ Cooper JM Hickner JR Hoff'an et al. (2001) ArticleTitlePrinciples of appropriate use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods Ann Intern Med 134 479–86 Occurrence Handle11255524 Occurrence Handle1:STN:280:DC%2BD3M7mt1KltA%3D%3D

    PubMed  CAS  Google Scholar 

  35. AM Gadomski (1993) ArticleTitlePotential interventions for preventing pneumonia among young children: lack of effect of antibiotic treatment for upper respiratory infections Pediatr Infect Dis J 12 115–20 Occurrence Handle8426767 Occurrence Handle1:STN:280:DyaK3s7kvFOnsw%3D%3D Occurrence Handle10.1097/00006454-199302000-00002

    Article  PubMed  CAS  Google Scholar 

  36. T Heikkinen O Ruuskanen T Ziegler M Waris H Puhakka (1995) ArticleTitleShort-term use of amoxicillin-clavulanate during upper respiratory tract infection for prevention of acute otitis media J Pediatr 126 313–6 Occurrence Handle7844685 Occurrence Handle10.1016/S0022-3476(95)70569-4 Occurrence Handle1:STN:280:DyaK2M7kslWgsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  37. Arroll B, Kenealy T. Antibiotics for the common cold and purulent rhinitis. Cochrane Database Syst Rev 2005 Jul 20;3:CD000247

  38. SF Dowell SM Marcy WR Philips MA Gerber B Schwartz (1998) ArticleTitleOtitis media–principles of judicious use of antimicrobial agents Pediatrics 101 IssueIDSuppl 165–71

    Google Scholar 

  39. B Schwartz SM Marcy WR Phillips MA Gerber SF Dowell (1998) ArticleTitlePharyngitis – principles of judicious use of antimicrobial agents Pediatrics 101 IssueIDSuppl 171–4

    Google Scholar 

  40. KL O'Brien SF Dowell B Schwartz SM Marcy WR Phillips MA Gerber (1998) ArticleTitleAcute sinusitis – principles of judicious use of antimicrobial agents Pediatrics 101 IssueIDSuppl 174–7

    Google Scholar 

  41. KL O'Brien SF Dowell B Schwartz SM Marcy WR Phillips MA Gerber (1998) ArticleTitleCough illness/bronchitis – principles of judicious use of antimicrobial agents Pediatrics 101 IssueIDSuppl 178–81

    Google Scholar 

  42. N Rosenstein WR Philips MA Gerber SM Marcy B Schwartz SF Dowell (1998) ArticleTitleThe common cold – principles of judicious use of antimicrobial agents Pediatrics 101 IssueIDSuppl 181–4

    Google Scholar 

  43. InstitutionalAuthorNameSubcommittee on Management of Sinusitis and Committee on Quality Improvement (2001) ArticleTitleClinical practice guideline: management of sinusitis Pediatrics 108 798–808 Occurrence Handle10.1542/peds.108.4.1033

    Article  Google Scholar 

  44. InstitutionalAuthorNameOtological Society of Japan InstitutionalAuthorNameJapan Society for Pediatric Oto-Rhino-Laryngology InstitutionalAuthorNameJapan Society for Infectious Disease in Otolaryngology (2006) ArticleTitleGuidelines for the management of acute otitis media in children J Jpn Pediatr Otorhinolaryngol 27 71–107

    Google Scholar 

  45. Japanese Society for Pediatric Pulmonology and Japanese Society for Pediatric Infectious Disease. Guideline for the management of respiratory infectious disease in children in Japan 2004. In: Uehara S, Sunakawa, editors. Tokyo: Kyowa Kikaku; 2004. p. 1–33

  46. HR Jousimies-Somer S Savolainen JS Ylikoski (1988) ArticleTitleMacroscopic purulence, leukocyte counts, and bacterial morphotypes in relation to culture findings for sinus secretions in acute maxillary sinusitis J Clin Microbiol 26 1926–33 Occurrence Handle3182987 Occurrence Handle1:STN:280:DyaL1M%2FjsVKktw%3D%3D

    PubMed  CAS  Google Scholar 

  47. A Heald R Auckenthaler F Borst O Delaspre D Germann L Matter et al. (1993) ArticleTitleAdult bacterial nasopharyngitis: a clinical entity? J Gen Intern Med 8 667–73 Occurrence Handle8120682 Occurrence Handle10.1007/BF02598283 Occurrence Handle1:STN:280:DyaK2c7msFymsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  48. M Almager I Kahane JM Wiesel S Yatziv (1985) ArticleTitleHuman ciliated epithelial cells from nasal polyps as an experimental model for Mycoplasma pneumoniae infection Infect Immun 48 552–5

    Google Scholar 

  49. MG Gabridg (1983) ArticleTitleAttachment of Mycoplasma pneumoniae to tracheal monoplayer outgrowths Yale J Biol Med 56 657–63

    Google Scholar 

  50. M Morozumi S Iwata H Endo T Oishi S Ohnari N Kawamura et al. (2003) ArticleTitleNew PCR for rapid identification of Mycoplasma pneumoniae in clinical specimens from children with respiratory tract infections Jpn J Chemother 51 289–99 Occurrence Handle1:CAS:528:DC%2BD3sXksVyisbY%3D

    CAS  Google Scholar 

  51. RK Budhani JK Struthers (1997) ArticleTitleThe use of Sorbarod biofilms to study the antimicrobial susceptibility of a strain of Streptococcus pneumoniae J Antimicrob Chemother 40 601–2 Occurrence Handle9372435 Occurrence Handle10.1093/jac/40.4.601 Occurrence Handle1:CAS:528:DyaK2sXntl2gs70%3D

    Article  PubMed  CAS  Google Scholar 

  52. RK Budhani JK Struthers (1998) ArticleTitleInteraction of Streptococcus pneumoniae and Moraxella catarrhalis: investigation of the indirect pathogenic role of beta-lactamase-producing moraxella by use of a continuous-culture biofilm system Antimicrob Agents Chemother 42 2521–6 Occurrence Handle9756750 Occurrence Handle1:CAS:528:DyaK1cXms1CqurY%3D

    PubMed  CAS  Google Scholar 

  53. CD Ehrlich R Veeh X Wang JW Costerton JD Hayes FZ Hu et al. (2002) ArticleTitleMucosal biofilm formation on middle-ear mucosa in the chinchilla model of otitis media JAMA 287 1710–5 Occurrence Handle11926896 Occurrence Handle10.1001/jama.287.13.1710

    Article  PubMed  Google Scholar 

  54. TF Murphy C Kirkham (2002) ArticleTitleBiofilm formation by nontypeable Haemophilus influenzae: strain variability, outer membrane antigen expression and role of pili BMC Microbiol 15 2–7

    Google Scholar 

  55. DR Cundell NP Gerard I Idanpaan-Heikkila EI Tuomanen (1995) ArticleTitleStreptococcus pneumoniae anchor to activate human cells by receptor for platelet-activating factor Nature 377 435–8 Occurrence Handle7566121 Occurrence Handle10.1038/377435a0 Occurrence Handle1:CAS:528:DyaK2MXos1Slsrw%3D

    Article  PubMed  CAS  Google Scholar 

  56. A Ring JN Weiser EI Tuomanen (1998) ArticleTitlePneumococcal trafficking across the blood-brain barrier. Molecular analysis of a novel bi-directional pathway J Clin Invest 102 347–60 Occurrence Handle9664076 Occurrence Handle1:CAS:528:DyaK1cXkslOkt7k%3D Occurrence Handle10.1172/JCI2406

    Article  PubMed  CAS  Google Scholar 

  57. JR Weber D Freyer C Alexader NW Schroder A Reiss C Kuster et al. (2003) ArticleTitleRecognition of pneumococcal peptideglycan: an expanded, pivotal role for LPS binding protein Immunity 19 155–6 Occurrence Handle10.1016/S1074-7613(03)00205-X

    Article  Google Scholar 

  58. MM Farley DS Stephan MH Mulks MD Cooper JV Bricker SS Mirra et al. (1986) ArticleTitlePathogenesis of IgA1 protease-producing and –nonproducing Haemophilus influenzae in human nasopharyngeal organ culture J Infect Dis 154 752–9 Occurrence Handle3534106 Occurrence Handle1:STN:280:DyaL2s%2FjsFSktA%3D%3D

    PubMed  CAS  Google Scholar 

  59. JW St. Geme Suffix3rd S Falkow (1990) ArticleTitleHaemophilus influenzae adheres to and enters cultured human epithelial cells Infect Immun 58 4036–44 Occurrence Handle2254028 Occurrence Handle1:CAS:528:DyaK3MXitFOgtA%3D%3D

    PubMed  CAS  Google Scholar 

  60. J Foragren A Samuelson A Ahlin J Jonnasson B Rynnel-Dagoo A Lindberg (1994) ArticleTitleHaemophilus influenzae resides and multiplies intracellularly in human adenoid tissue as demonstrated by in situ hybridization and bacterial viability assay Infect Immun 62 673–9

    Google Scholar 

  61. MR Ketterer JQ Shao DB Hornick B Buscher VK Bandi MA Apicella (1999) ArticleTitleInfection of primary human bronchial epithelial cells by Haemophilus influenzae: macropinnocytosis as a mechanism of airway epithelial cell entry Infect Immun 67 4161–70 Occurrence Handle10417188 Occurrence Handle1:CAS:528:DyaK1MXkvVKlt70%3D

    PubMed  CAS  Google Scholar 

  62. WE Swords BA Buscher K Ver Steeg Ii A Preston WA Nichols JN Weiser et al. (2000) ArticleTitleNon-typable Haemophilus influenzae adhere to and invade human bronchial epithelial cells via an interaction of lipooligosaccharide with the PAF receptor Mol Microbiol 37 13–37 Occurrence Handle10931302 Occurrence Handle10.1046/j.1365-2958.2000.01952.x Occurrence Handle1:CAS:528:DC%2BD3cXlsFOksb4%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Masatoshi Konno

    Present address: , 37-10 Sengoku 3-chome, Bunkyo-ku, Tokyo, 112-0011, Japan

Authors and Affiliations

  1. Teikyo University School of Medicine, Tokyo, Japan

    Masatoshi Konno

  2. Nagoya City University Graduate School of Medical Sciences, Medical School, Nagoya, Japan

    Shunkichi Baba

  3. Kyoto University, Graduate School of Medicine, Faculty of Medicine, Kyoto, Japan

    Haruki Mikawa

  4. Nagasaki University School of Medicine and Dentistry, Nagasaki, Japan

    Kohei Hara & Shigeru Kohno

  5. The Jikei University School of Medicine, Tokyo, Japan

    Fumio Matsumoto & Hiroshi Moriyama

  6. Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Kimitaka Kaga

  7. Fujita Health University School of Medicine, Tokyo, Japan

    Tadao Nishimura

  8. Tohoku University, Graduate School of Medicine and School of Medicine, Sendai, Japan

    Toshimitsu Kobayashi

  9. Gunma University, Graduate School of Medicine, Maebashi, Japan

    Nobuhiko Furuya & Akihiro Morikawa

  10. Graduate School of Medicine, Chiba University, Chiba, Japan

    Yoshitaka Okamoto

  11. Kanazawa University, Graduate School of Medical Science, School of Medicine, Kanazawa, Japan

    Mituru Furukawa & Shoichi Koizumi

  12. Wakayama Medical University, Wakayama, Japan

    Noboru Yamanaka

  13. Kawasaki Medical School, Okayama, Japan

    Toshiharu Matsushima

  14. Tokyo Medical and Dental University, Graduate School of Medicine, Tokyo, Japan

    Yasuyuki Yoshizawa

  15. Hokkaido University, Graduate School of Medicine, Sapporo, Japan

    Kunihiko Kobayashi

  16. Kitasato University School of Medicine, Sagamihara, Japan

    Keisuke Sunakawa & Matsuhisa Inoue

  17. Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Tokyo, Japan

    Kimiko Ubukata

Authors
  1. Masatoshi Konno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shunkichi Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haruki Mikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kohei Hara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fumio Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kimitaka Kaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tadao Nishimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshimitsu Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nobuhiko Furuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroshi Moriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yoshitaka Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Mituru Furukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Noboru Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Toshiharu Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yasuyuki Yoshizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Shigeru Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Kunihiko Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Akihiro Morikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Shoichi Koizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Keisuke Sunakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Matsuhisa Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Kimiko Ubukata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masatoshi Konno.

About this article

Cite this article

Konno, M., Baba, S., Mikawa, H. et al. Study of nasopharyngeal bacterial flora. Variations in nasopharyngeal bacterial flora in schoolchildren and adults when administered antimicrobial agents. J Infect Chemother 13, 235–254 (2007). https://doi.org/10.1007/s10156-007-0533-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10156-007-0533-8

Key words

Search

Navigation