Nasopharyngeal colonisation in healthy children in Greece

Abstract number: 1135_296

Papavasileiou H., Makri A., Papavasileiou L., Agathokleous X., Andrianopoulou I., Varveri M., Kanaki T., Vogiatzi A.

Colonization of nasopharynx by potential respiratory pathogens is established in early childhood, although this varies greatly according to locality, individual and social factors.

Aim:  

The aim of this study was to investigate the prevalence of the nasopharyngeal carriage of respiratory pathogens and identify factors affecting colonization in healthy children in an area of Athens inhabited mainly by ethnic minorities.

Material and method:  

From January 2003 up to May 2004 with exception of summer months, 392 nasopharyngeal swabs from equal in number healthy children were obtained. 38 of the children were under the age of 6 (group A) and the rest (354) from 6 to 10 years-old (group B). 45% of the above children either had not been or incompletely vaccinated against H. Influenzae type b (Hib). The samples were cultured in blood and chocolate agar for 48 h. Identification of the isolates and sensitivity to antibiotics was performed by disk diffusion method following the guidelines of NCCLS.

Results:  

Out of 392 swabs, 285 (73%) were found positive to one or more pathogens. From these in 74 (26%) were isolated 2 bacteria and in 8 (3%) three. The pathogens isolated were 307 (71%) H. influenzae, 38 (8,8%) M. catarrhalis, 24 (5,5%) Candida spp., 15 (3,5%) S. pyogenes (GAS), 8 (1,8%) Neisseriae spp., 4 (0,9%) S. aureus, 1 (0,2%) Streptococcus Group C and 36 (8,3%) Gram-bacteria. From the 38 group A children, 27 (59%) were found positive for H. influenzae, 6 (13%) for M. catarrhalis, 1 (2%) for GAS, 1 (2%) for Candida spp., 1 (2%) for S. aureus and 10 (22%) for Gram-bacteria. 9 swabs (24%) were positive for two pathogens and 1 (5%) for three. Significant resistance had H. influenzae to Cotrimo (31%), M. catarrhalis to Ampicillin (76%) and S. aureus to Penicillin (100%).

Conclusions:  

H. influenzae is the prevalent colonist in the nasopharynx of the examined children, possibly due to the fact that these had not been at all or partially vaccinated against Hib. Group A children had been colonized in higher frequency by Gram-bacteria. Rhinopharyngeal colonization by respiratory pathogens on these children might have a strong relationship with the socioeconomic level and the way of living of these populations. Therefore, antimicrobial restrictive guidelines should be tailored to local microbiologic sceneries.