感染和未感染艾滋病毒的儿童及其父母中鼻咽病毒与致病细菌的关联。
Association of nasopharyngeal viruses and pathogenic bacteria in children and their parents with and without HIV.
作者信息
Khan Tila, Das Ranjan Saurav, Chaudhary Amrita, Chatterjee Jyotirmoy, Bhattacharya Sangeeta Das
机构信息
School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, 721302, India.
出版信息
Pneumonia (Nathan). 2021 May 5;13(1):8. doi: 10.1186/s41479-021-00088-5.
BACKGROUND
Bacteria and respiratory viruses co-occur in the nasopharynx, and their interactions may impact pathogenesis of invasive disease. Associations of viruses and bacteria in the nasopharynx may be affected by HIV.
METHODS
We conducted a nested case-control study from a larger cohort study of banked nasopharyngeal swabs from families with and without HIV in West Bengal India, to look at the association of viruses and bacteria in the nasopharynx of parents and children when they are asymptomatic. Quantitative polymerase chain reaction for 4 bacteria and 21 respiratory viruses was run on 92 random nasopharyngeal swabs from children--49 from children living with HIV (CLH) and 43 from HIV uninfected children (HUC)-- and 77 swabs from their parents (44 parents of CLH and 33 parents of HUC).
RESULTS
Bacteria was found in 67% of children, viruses in 45%, and both in 27% of child samples. Staphylococcus aureus (53%) was the most common bacteria, followed by Streptococcus pneumoniae (pneumococcus) (37%) in children and parents (53, 20%). Regardless of HIV status, viruses were detected in higher numbers (44%) in children than their parents (30%) (p = 0.049), particularly rhinovirus (p = 0.02). Human rhinovirus was the most frequently found virus in both CLH and HUC. Children with adenovirus were at six times increased risk of also having pneumococcus (Odds ratio OR 6, 95% CI 1.12-31.9) regardless of HIV status. In addition, the presence of rhinovirus in children was associated with increased pneumococcal density (Regression coeff 4.5, 1.14-7.9). In CLH the presence of rhinovirus increased the risk of pneumococcal colonization by nearly sixteen times (OR 15.6, 1.66-146.4), and, pneumococcus and S. aureus dual colonization by nearly nine times (OR 8.7).
CONCLUSIONS
Children more frequently carried viruses regardless of HIV status. In CLH the presence of rhinovirus, the most frequently detected virus, significantly increased co-colonization with pneumococcus and S. aureus.
背景
细菌和呼吸道病毒在鼻咽部共同存在，它们之间的相互作用可能会影响侵袭性疾病的发病机制。鼻咽部病毒与细菌的关联可能会受到艾滋病毒的影响。
方法
我们在印度西孟加拉邦一项针对有或没有艾滋病毒的家庭储存鼻咽拭子的更大队列研究中进行了一项巢式病例对照研究，以观察父母和儿童无症状时鼻咽部病毒与细菌的关联。对来自儿童的92份随机鼻咽拭子进行了4种细菌和21种呼吸道病毒的定量聚合酶链反应，其中49份来自感染艾滋病毒的儿童（CLH），43份来自未感染艾滋病毒的儿童（HUC），以及来自他们父母的77份拭子（44名CLH的父母和33名HUC的父母）。
结果
在67%的儿童样本中发现了细菌，45%的样本中发现了病毒，27%的样本中两者都有。金黄色葡萄球菌（53%）是最常见的细菌，其次是肺炎链球菌（肺炎球菌）（儿童中为37%，父母中为53%、20%）。无论艾滋病毒感染状况如何，儿童中检测到病毒的比例（44%）高于其父母（30%）（p = 0.049），尤其是鼻病毒（p = 0.02）。人鼻病毒是CLH和HUC中最常发现的病毒。无论艾滋病毒感染状况如何，感染腺病毒的儿童感染肺炎球菌的风险增加6倍（比值比OR 6，95%可信区间1.12 - 31.9）。此外，儿童中鼻病毒的存在与肺炎球菌密度增加有关（回归系数4.5，1.14 - 7.9）。在CLH中，鼻病毒的存在使肺炎球菌定植风险增加近16倍（OR 15.6，1.66 - 146.4），以及肺炎球菌和金黄色葡萄球菌双重定植风险增加近9倍（OR 8.7）。
结论
无论艾滋病毒感染状况如何，儿童携带病毒的频率更高。在CLH中，最常检测到的病毒鼻病毒的存在显著增加了与肺炎球菌和金黄色葡萄球菌的共同定植。
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