Early acquisition and high nasopharyngeal co-colonisation by Streptococcus pneumoniae and three respiratory pathogens amongst Gambian new-borns and infants

BMC Infectious Diseases

Martin Antonio²  Richard A Adegbola⁴  Christian Bottomley¹  Michael R Barer³  Brenda A Kwambana³ 

[1] Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK;Bacterial Diseases Programme, Medical Research Council Laboratories (UK), Atlantic Boulevard, Banjul, P. O. Box 273, The Gambia;Department of Infection, Immunity, and Inflammation, Maurice Shock Medical Sciences Building, University Road, Leicester, LE1 9HN, UK;Infectious Diseases Development, Global Health Program, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA

关键词: respiratory pathogens;    PCR;    Nasopharyngeal;   

Others  :  1175674
DOI  :  10.1186/1471-2334-11-175

 received in 2011-02-07, accepted in 2011-06-20,  发布年份 2011

【 摘 要 】

Background

Although Haemophilus influenzae type b (Hib), Staphylococcus aureus and Moraxella catarrhalis are important causes of invasive and mucosal bacterial disease among children, co-carriage with Streptococcus pneumoniae during infancy has not been determined in West Africa.

Methods

Species specific PCR was applied to detect each microbe using purified genomic DNA from 498 nasopharyngeal (NP) swabs collected from 30 Gambian neonates every two weeks from 0 to 6 months and bi-monthly up to 12 months.

Results

All infants carried S. pneumoniae, H. influenzae and M. catarrhalis at several time points during infancy. S.pneumoniae co-colonized the infant nasopharynx with at least one other pathogen nine out of ten times. There was early colonization of the newborns and neonates, the average times to first detection were 5, 7, 3 and 14 weeks for S. pneumoniae, H. influenzae, M. catarrhalis and S. aureus respectively. The prevalence of S. pneumoniae, H. influenzae and M. catarrhalis increased among the neonates and exceeded 80% by 13, 15 and 23 weeks respectively. In contrast, the prevalence of S. aureus decreased from 50% among the newborns to 20% amongst nine-week old neonates. S. pneumoniae appeared to have a strong positive association with H. influenzae (OR 5.03; 95% CI 3.02, 8.39; p < 0.01) and M. catarrhalis (OR 2.20; 95% CI 1.29; p < 0.01) but it was negatively associated with S. aureus (OR 0.53; 95% CI 0.30, 0.94; p = 0.03).

Conclusion

This study shows early acquisition and high co-carriage of three important respiratory pathogens with S. pneumoniae in the nasopharyngeal mucosa among Gambian neonates and infants. This has important potential implications for the aetiology of respiratory polymicrobial infections, biofilm formation and vaccine strategies.

【 授权许可】

   
2011 Kwambana et al; licensee BioMed Central Ltd.

【 图 表 】

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