Striking differences in the nasopharyngeal flora of healthy Angolan, Brazilian and Dutch children less than 5 years old.
Community-acquired pneumonia from enteric gram-negative bacilli is more common in developing than in industrialized countries. We investigated the nasopharyngeal flora in healthy children from Angola, Brazil and The Netherlands to see whether enteric gram-negative bacilli are more often part of the commensal flora in developing countries. Nasopharyngeal specimens were collected from children aged between 4 months and 5 years in day-care centres and immunization clinics. Children who had received antibiotics or were malnourished were excluded. Brazilian and Angolan children had a higher number of household members than Dutch children (5.5 and 7 vs 3.9 mean number of household members, respectively) (p < 0.0001). Enteric and non-fermentative gram-negative bacilli were much more prevalent in Brazilian (50%) and Angolan (57%) children than in Dutch (4%) children (p < 0.0001). By univariate analysis, carriage of enteric gram-negative bacilli was associated with the number of household members (r = 0.26; p < 0.001). The high carriage rate of enteric gram-negative bacilli in children from Angola and Brazil may explain why enteric gram-negative bacilli are a common cause of pneumonia in developing countries.
Wolf
B
B
Department of Pediatrics, St Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands. mjbwolf@knoware.nl
Gama
A
A
Rey
L
L
Fonseca
W
W
Roord
J
J
Fleer
A
A
Verhoef
J
J
D000810:Angola / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D004755:Enterobacteriaceae / Q000145:classification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D009426:Netherlands / Q000453:epidemiology