Vanker Aneesa, Nduru Polite M, Barnett Whitney, Dube Felix S, Sly Peter D, Gie Robert P, Nicol Mark P, Zar Heather J
Dept of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and SAMRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
Dept of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa.
ERJ Open Res. 2019 Feb 4;5(1). doi: 10.1183/23120541.00052-2018. eCollection 2019 Feb.
Indoor air pollution (IAP) or environmental tobacco smoke (ETS) exposure may influence nasopharyngeal carriage of bacterial species and development of lower respiratory tract infection (LRTI). The aim of this study was to longitudinally investigate the impact of antenatal or postnatal IAP/ETS exposure on nasopharyngeal bacteria in mothers and infants. A South African cohort study followed mother-infant pairs from birth through the first year. Nasopharyngeal swabs were taken at birth, 6 and 12 months for bacterial culture. Multivariable and multivariate Poisson regression investigated associations between nasopharyngeal bacterial species and IAP/ETS. IAP exposures (particulate matter, carbon monoxide, nitrogen dioxide, volatile organic compounds) were measured at home visits. ETS exposure was measured through maternal and infant urine cotinine. Infants received the 13-valent pneumococcal and B conjugate vaccines. There were 881 maternal and 2605 infant nasopharyngeal swabs. Antenatal ETS exposure was associated with carriage in mothers (adjusted risk ratio (aRR) 1.73 (95% CI 1.03-2.92)) while postnatal ETS exposure was associated with carriage in infants (aRR 1.14 (95% CI 1.00-1.30)) Postnatal particulate matter exposure was associated with the nasopharyngeal carriage of (aRR 1.68 (95% CI 1.10- 2.57)) or (aRR 1.42 (95% CI 1.03-1.97)) in infants. Early-life environmental exposures are associated with an increased prevalence of specific nasopharyngeal bacteria during infancy, which may predispose to LRTI.
室内空气污染（IAP）或环境烟草烟雾（ETS）暴露可能会影响细菌种类的鼻咽携带情况以及下呼吸道感染（LRTI）的发生。本研究的目的是纵向调查产前或产后IAP/ETS暴露对母婴鼻咽部细菌的影响。一项南非队列研究对母婴对从出生到一岁进行了跟踪。在出生时、6个月和12个月采集鼻咽拭子进行细菌培养。多变量和多变量泊松回归研究了鼻咽部细菌种类与IAP/ETS之间的关联。在家庭访视时测量IAP暴露（颗粒物、一氧化碳、二氧化氮、挥发性有机化合物）。通过母婴尿可替宁测量ETS暴露。婴儿接种了13价肺炎球菌和B型结合疫苗。共有881份母亲和2605份婴儿鼻咽拭子。产前ETS暴露与母亲携带相关（调整风险比（aRR）1.73（95%CI 1.03 - 2.92）），而产后ETS暴露与婴儿携带相关（aRR 1.14（95%CI 1.00 - 1.30））。产后颗粒物暴露与婴儿鼻咽部携带（aRR 1.68（95%CI 1.10 - 2.57））或（aRR 1.42（95%CI 1.03 - 1.97））相关。生命早期的环境暴露与婴儿期特定鼻咽部细菌的患病率增加有关，这可能易导致下呼吸道感染。
