Study of nasopharyngeal bacterial flora. Second report. Variations in nasopharyngeal bacterial flora in children aged 6 years or younger when administered antimicrobial agents. Part 1

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 12; no. 5; pp. 287 - 304
• Main Authors: Konno, Masatoshi, Baba, Shunkichi, Mikawa, Haruki, Hara, Kohei, Kohno, Shigeru, Matsumoto, Fumio, Kaga, Kimitaka, Nishimura, Tadao, Kobayashi, Toshimitsu, Furuya, Nobuhiko, Morikawa, Akihiro, Moriyama, Hiroshi, Okamoto, Yoshitaka, Furukawa, Mituru, Koizumi, Shoichi, Yamanaka, Noboru, Matsushima, Toshiharu, Yoshizawa, Yasuyuki, Kobayashi, Kunihiko, Sunakawa, Keisuke, Inoue, Matsuhisa, Ubukata, Kimiko
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-10-2006
• Subjects: Acute otitis media; Acute upper respiratory tract infection; Age Factors; Ampicillin Resistance; Anti-Infective Agents - therapeutic use; Bacteria; beta-Lactamases - metabolism; Child; Child, Preschool; Female; Haemophilus Infections - drug therapy; Haemophilus Infections - microbiology; Haemophilus influenzae; Haemophilus influenzae - enzymology; Haemophilus influenzae - genetics; Haemophilus influenzae - isolation & purification; Humans; Infant; Male; Nasopharyngeal bacterial flora; Nasopharynx - drug effects; Nasopharynx - microbiology; Otitis Media - drug therapy; Otitis Media - microbiology; Pneumococcal Infections - drug therapy; Pneumococcal Infections - microbiology; Polymerase Chain Reaction - methods; Rapid diagnosis; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - microbiology; Streptococcus pneumoniae; Streptococcus pneumoniae - genetics; Streptococcus pneumoniae - isolation & purification; Rapid diagnosis; Acute upper respiratory tract infection; Nasopharyngeal bacterial flora; Acute otitis media; Haemophilus influenzae; Streptococcus pneumoniae
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1007/s10156-006-0468-5

In our first report, we investigated nasopharyngeal bacterial flora related to penicillin-resistant Streptococcus pneumoniae (PRSP) and β-lactamase-negative ampicillin-resistant Haemophilus influenzae (BLNAR) and their relation to acute upper respiratory tract infection (AURTI). This report analyzes the results of a study of nasopharyngeal bacterial flora before the administration of antimicrobial agents in 172 AURTI patients aged 6 years or younger. In addition to Gram staining, microscopic observation, and culturing, a polymerase chain reaction (PCR) method was used to identify PRSP (gPRSP) and BLNAR (gBLNAR) drug-resistant genes. Of the patients analyzed, 90% had acute otitis media (AOM) and were aged 2 years or younger. The antimicrobial agents administered were amoxicillin (34%), clavulanic acid/amoxicillin (11%), cefditren pivoxil (CDTR-PI) (43%), and others (12%). This was particularly true for patients administered CDTR-PI, among whom there were many who had already suffered one or more episodes of AOM by the age of 1 year or younger, and many in which gPRSP were detected (P<0.01). There was a significant relation between the degree of nasopharyngeal inflammation indicated by leukocyte infiltration images and the amount of S. pneumoniae and H. influenzae detected, which are the main pathogenic bacteria causing AOM (P<0.01). In addition to leukocyte infiltration images, there were cases in which shedding of ciliated cells was observed and/or giant monocytic cells. Both nasopharyngeal leukocyte infiltration images and/or shed cell findings observed in infant AURTI cases are important indices for the prompt detection of gPRSP and/or gBLNAR and appropriate doses of antimicrobial agents.