Document Detail

Individual risk factors associated with nasopharyngeal colonization with Streptococcus pneumoniae and Haemophilus influenzae: a Japanese birth cohort study.
MedLine Citation:
PMID:  23411622     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The first step in a bacterial disease is the establishment of nasopharyngeal carriage.
METHODS: We conducted a birth cohort study to identify factors associated with colonization in healthy children and evaluate the serotype distributions and resistances of Streptococcus pneumoniae/Haemophilus influenzae. Nasopharyngeal cultures were obtained from 349 subjects at 5 time points coinciding with health checkups (4, 7, 10, 18 and 36 months).
RESULTS: A total of 551 S. pneumoniae (penicillin resistance rate: 46.3%) and 301 H. influenzae (ampicillin resistance rate: 44.5%) isolates were obtained from 1654 samples. In this study, 47.5% and 60.9% of S. pneumoniae isolates were included in the serotypes of 7- and 13-valent pneumococcal conjugate vaccines, respectively. Analyzing by Cox proportional hazards models, cohabiting older sibling(s) attending day-care (hazard ratios: 2.064-3.518, P < 0.001) and an early start of day-care attendance by the subjects themselves (2.259-2.439, P < 0.001) were associated with a higher risk of early colonization regardless of their susceptibility. Recent exposure to antimicrobials was also significantly associated with increased risk of colonization (odds ratios: 2.032-2.999, P < 0.001) but not with resistance rates. This data indicated that introduction of appropriate antimicrobial usage in areas of overuse of antimicrobials could contribute to lower colonization of S. pneumoniae/H. influenzae, resulting in a decrease in the absolute number of resistant isolates.
CONCLUSIONS: Strategies to control transmission at day-care centers or from older sibling(s) as well as appropriate use of antimicrobials are essential for reducing colonization and the absolute number of resistant isolates.
Taketo Otsuka; Bin Chang; Takatoshi Shirai; Atsushi Iwaya; Akihito Wada; Noboru Yamanaka; Minoru Okazaki;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  32     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-11     Completed Date:  2014-02-06     Revised Date:  2014-02-24    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  709-14     Citation Subset:  IM    
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MeSH Terms
Carrier State / epidemiology*,  microbiology
Cohort Studies
Haemophilus Infections / epidemiology*,  microbiology
Haemophilus influenzae / classification,  drug effects,  isolation & purification*
Infant, Newborn
Japan / epidemiology
Microbial Sensitivity Tests
Nasopharynx / microbiology*
Pneumococcal Infections / epidemiology*,  microbiology
Risk Factors
Streptococcus pneumoniae / classification,  drug effects,  isolation & purification*
Takeshi Ono / ; Jun Nirei / ; Kou Matsui / ; Yasuhiro Shoji / ; Michihide Nakamure / ; Koyata Fujii / ; Satoko Matsunaga / ; Yasuko Masuda / ; Kenichi Komiyama / ; Kazunaga Yoshida / ; Yukio Ishikawa / ; Muneki Hotomi /
Comment In:
Pediatr Infect Dis J. 2014 Feb;33(2):228   [PMID:  24413412 ]
Pediatr Infect Dis J. 2014 Feb;33(2):228-9   [PMID:  24413413 ]

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