Tsai Ming-Han, Huang Shu-Huan, Chen Chyi-Liang, Chiu Chih-Yung, Hua Man-Chin, Liao Sui-Ling, Yao Tsung-Chieh, Lai Shen-Hao, Yeh Kuo-Wei, Wang Mei-Ping, Huang Jing-Long
From the *Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan; †Chang Gung University, College of Medicine, Taoyuan, Taiwan; ‡Department of Medical Laboratory, Chang Gung Memorial Hospital, Keelung, Taiwan; §Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; ¶Division of Allergy, Asthma, and Rheumatology, and ‖Division of Pulmonology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Pediatr Infect Dis J. 2015 Jun;34(6):652-8. doi: 10.1097/INF.0000000000000688.
For acute respiratory diseases caused by bacteria, colonization in the respiratory tracts is often the first sign, although nasopharynx is the major source of secretions containing pathogens. To understand the pathogenesis of respiratory tract diseases, it is important to analyze the establishment of nasopharyngeal bacterial colonization.
Infants with nasopharyngeal swabs were examined at the age of 1, 2, 4, 6 and 12 months for the detection of pathogens, including Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Staphylococcus aureus. The methods used for detection were bacterial culture and multiplex polymerase chain reaction.
From January 2012 to August 2013, a total of 320 neonates were enrolled, and 120 of them completed the first 12-month study. Staphylococcus aureus was the most common pathogen at all 5 time points while the rates declined; in contrast, the other 4 increased during the first year of life. Of our series, the multiplex polymerase chain reaction detection rates were higher than those of bacterial culture. More than 50% of Staphylococcus aureus was methicillin-resistant, and the trend decreased in the same period. In the analysis of factors associated with the development of infant wheeze, infants with maternal atopy [odds ratio (OR): 3.26; 95% confidence interval (CI): 1.20-8.88; P = 0.02] and pneumococcal colonization (OR: 15.64; 95% CI: 3.25-75.35; P = 0.001) had higher rates of wheeze.
Bacterial interactions may result in differing pathogen prevalence in the first year of life. In addition, nasopharyngeal pneumococcal colonization may have an effect on the risk of infant wheeze. The result could help clinicians to clarify the relation between bacterial colonization and respiratory illnesses in infancy.
对于由细菌引起的急性呼吸道疾病，呼吸道定植通常是首要迹象，尽管鼻咽部是含有病原体分泌物的主要来源。为了解呼吸道疾病的发病机制，分析鼻咽部细菌定植的建立情况很重要。
对1、2、4、6和12月龄的婴儿进行鼻咽拭子检查，以检测包括肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、化脓性链球菌和金黄色葡萄球菌在内的病原体。检测方法为细菌培养和多重聚合酶链反应。
2012年1月至2013年8月，共纳入320例新生儿，其中120例完成了为期12个月的首次研究。金黄色葡萄球菌在所有5个时间点都是最常见的病原体，但其发生率呈下降趋势；相比之下，其他4种病原体在生命的第一年中发生率上升。在我们的研究系列中，多重聚合酶链反应的检测率高于细菌培养。超过50%的金黄色葡萄球菌对甲氧西林耐药，且同期呈下降趋势。在分析与婴儿喘息发展相关的因素时，母亲有特应性的婴儿[比值比（OR）：3.26；95%置信区间（CI）：1.20 - 8.88；P = 0.02]和肺炎球菌定植（OR：15.64；95% CI：3.25 - 75.35；P = 0.001）的喘息发生率更高。
细菌相互作用可能导致生命第一年中不同病原体的流行情况不同。此外，鼻咽部肺炎球菌定植可能对婴儿喘息风险有影响。该结果有助于临床医生阐明婴儿期细菌定植与呼吸道疾病之间的关系。
