健康儿童的口咽和鼻腔金黄色葡萄球菌携带情况。
Oropharyngeal and nasal Staphylococcus aureus carriage by healthy children.
作者信息
Esposito Susanna, Terranova Leonardo, Zampiero Alberto, Ierardi Valentina, Rios Walter Peves, Pelucchi Claudio, Principi Nicola
机构信息
Department of Pathophysiology and Transplantation, Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milano, Italy.
Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
出版信息
BMC Infect Dis. 2014 Dec 31;14:723. doi: 10.1186/s12879-014-0723-9.
BACKGROUND
As healthy children are the main reservoir of respiratory pathogens and the main cause of bacterial diffusion in the community, it could be interesting to investigate the type of screening that should be used during the early years of life in order to obtain a more precise estimate of Staphylococcus aureus circulation. The aim of this study was to evaluate oropharyngeal and nasal S. aureus carriage in otherwise healthy children and adolescents aged 6-17 years.
METHODS
The oropharyngeal and nasal samples were collected in December 2013 from 497 healthy students attending five randomly selected schools in Milan, Italy, using an ESwab kit, and S. aureus was identified using the RIDA®GENE methicillin-resistant S. aureus (MRSA) system.
RESULTS
Two hundred and sixty-four subjects (53.1%) were identified as S. aureus carriers: 129 (25.9%) oropharyngeal carriers and 195 (39.2%) nasal carriers, of whom 60 (12.1%) were both oropharyngeal and nasal carriers. Oropharyngeal carriage increased with age (p < 0.001), whereas nasal carriage decreased. There was little or no agreement between oropharyngeal and nasal carriage in any of the age groups. MRSA was identified in only three cases (0.6%), always in nasal samples. There were no differences between the carriers and non-carriers in terms of the distribution of age, gender, ethnicity, the number of siblings in the household, exposure to passive smoking, previous clinical history, allergic sensitisation, or previous influenza, pneumococcal and meningococcal vaccinations. The frequency of male children was higher among the subjects with positive nasal and oropharyngeal swabs (66.7%) than among those with positive oropharyngeal swabs alone (46.4%; p = 0.02).
CONCLUSIONS
The oropharyngeal carriage of mainly methicillin-sensitive S. aureus is frequent in otherwise healthy children, including a relatively high proportion of those without nasal colonisation. These findings highlight the importance of adding throat to nasal screening when monitoring the circulation of S. aureus in the community.
背景
由于健康儿童是呼吸道病原体的主要储存宿主以及社区中细菌传播的主要原因，因此研究在儿童早期应采用何种筛查方式以更准确地估计金黄色葡萄球菌的传播情况可能会很有意义。本研究的目的是评估6至17岁健康儿童和青少年的口咽及鼻腔金黄色葡萄球菌携带情况。
方法
2013年12月，使用ESwab试剂盒从意大利米兰随机选取的五所学校的497名健康学生中采集口咽和鼻腔样本，并使用RIDA®GENE耐甲氧西林金黄色葡萄球菌（MRSA）系统鉴定金黄色葡萄球菌。
结果
264名受试者（53.1%）被鉴定为金黄色葡萄球菌携带者：129名（25.9%）为口咽携带者，195名（39.2%）为鼻腔携带者，其中60名（12.1%）既是口咽携带者又是鼻腔携带者。口咽携带率随年龄增长而增加（p < 0.001），而鼻腔携带率则下降。在任何年龄组中，口咽和鼻腔携带情况之间几乎没有一致性。仅在3例（0.6%）中鉴定出MRSA，且均在鼻腔样本中。携带者和非携带者在年龄、性别、种族、家庭中兄弟姐妹数量、被动吸烟暴露、既往临床病史、过敏致敏或既往流感、肺炎球菌和脑膜炎球菌疫苗接种的分布方面没有差异。鼻腔和口咽拭子阳性的受试者中男性儿童的频率（66.7%）高于仅口咽拭子阳性的受试者（46.4%；p = 0.02）。
结论
在其他方面健康的儿童中，主要是对甲氧西林敏感的金黄色葡萄球菌的口咽携带情况很常见，包括相当比例的无鼻腔定植者。这些发现突出了在社区监测金黄色葡萄球菌传播时，除鼻腔筛查外增加咽喉筛查的重要性。
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